Artikel
Impact of intratumoral radiofrequency ablation on circulating tumour cell release after cement augmentation of vertebral metastase
Auswirkungen der intratumoralen Radiofrequenzablation auf die Freisetzung zirkulierender Tumorzellen nach Zementaugmentation von Wirbelkörpermetastasen
Suche in Medline nach
Autoren
Veröffentlicht: | 25. Mai 2022 |
---|
Gliederung
Text
Objective: Cement augmentation via percutaneous vertebroplasty or kyphoplasty for treatment of spinal metastasis is a well-established treatment option. We assessed the impact of intraoperative intratumoral radiofrequency ablation before cement augmentation on dissemination of tumor cells into the vascular circulation.
Methods: We prospectively collected blood from patients with osteolytic spinal column metastases who underwent radiofrequency ablation prior immediately prior to cement augmentation and analysed the prevalence of circulating tumour cells (CTCs) at defined perioperative time-points: preoperatively, 5 and 20 minutes after cement augmentation, and 3-5 days postoperatively. We enrolled 21 patients, including 6 breast-, 6 lung-, 2 colorectal-, 2 prostate-, 2 urothel- and 3 other tumor entities. The study was approved by the local ethics committee (PV5709).
Results: Although in some cases a clear increase of CTCs after cement augmentation was observed, statistical analyses did not show a significant increase of EpCAM+/CK+ CTCs in samples taken 5 or 20 minutes post-cement augmentation (p=0.155 and p=0.138, respectively). In comparison to a previous study, where we reported a significant increase of CTCs after cement augmentation without radiofrequency ablation, the current data suggests a reduced dissemination of tumor cells due to the intraoperative thermal ablation technique.
Conclusion: Intratumoral radiofrequency ablation before cement augmentation of osteolytic spinal metastases apparently seems to reduce the number of mechanically disseminated CTCs hinting at an immediate destructive effect. Follow-up analysis will determine if the radiofrequency ablation also improved the local tumor control. Our findings provide a rationale for the use of intraoperative radiofrequency ablation to reduce the increased release of CTC after cement augmentation of osteolytic spinal metastases.