title: Percutaneous Computed Tomography-Guided Thermal Ablation of Pulmonary Osteosarcoma Metastases in Children.
abstract: BACKGROUND
  The role of percutaneous thermal ablation as a minimally-invasive treatment has not been evaluated in children under 18 years of age with pulmonary osteosarcoma metastases.
  
  
  METHODS
  This was a retrospective review of children treated with percutaneous thermal ablation for pulmonary osteosarcoma metastasis after prior surgical metastasectomy and chemotherapy. Selection criteria included number of pulmonary nodules <5 and nodule size smaller than 2 cm. Indications were discussed at multidisciplinary meetings. The goal was to achieve complete remission using percutaneous thermal ablation, thereby avoiding additional thoracotomies.
  
  
  RESULTS
  A total of 26 pulmonary nodules (mean size 6.7 mm, range 2-16 mm) were successfully treated by percutaneous computed tomography (CT)-guided thermal ablation in 11 children with osteosarcoma between the ages of 7 and 17 years (median 12.5). Patients denied post-procedure pain. Complications were limited to three pneumothoraxes (two minor, one major), and median hospitalization duration was 2.0 days. One patient died of rapidly progressive lumbar metastasis discovered 20 days post-ablation. Of the remaining 10 patients, local control at the ablation site was achieved, with median follow up of 16.7 months (range 4.1-41.8). Five patients remained in complete remission after median follow-up of 37.5 months, and five patients developed new metastases (one osseous, four pulmonary), of which two are in remission after subsequent treatment.
  
  
  CONCLUSIONS
  Percutaneous thermal ablation is a safe and effective minimally-invasive curative local treatment alternative for children with oligometastatic pulmonary osteosarcoma in whom surgical intervention is clinically contraindicated or unappealing.
authors.affiliation: Interventional Radiology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France. YevichMD@gmail.com.
authors.forename: Steven
authors.initials: S
authors.lastname: Yevich
authors.affiliation: Pediatric and Teenage Oncology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.
authors.forename: Natalie
authors.initials: N
authors.lastname: Gaspar
authors.affiliation: Interventional Radiology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.|Interventional Radiology Department, University Paris - Sud, Kremlin Bicetre, France.
authors.forename: Lambros
authors.initials: L
authors.lastname: Tselikas
authors.affiliation: Pediatric and Teenage Oncology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Brugières
authors.affiliation: Pediatric Oncology Department, Curie Institut, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Pacquement
authors.affiliation: Pediatric Oncology Department, Curie Institut, Paris, France.
authors.forename: Gudren
authors.initials: G
authors.lastname: Schleiermacher
authors.affiliation: Pediatric Oncology Department, Armand Trousseau Hospital, Paris, France.
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Tabone
authors.affiliation: Interventional Radiology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Pearson
authors.affiliation: Radiology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.
authors.forename: Sandra
authors.initials: S
authors.lastname: Canale
authors.affiliation: Anesthesia Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.
authors.forename: Jane
authors.initials: J
authors.lastname: Muret
authors.affiliation: Interventional Radiology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.|Interventional Radiology Department, University Paris - Sud, Kremlin Bicetre, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: de Baere
authors.affiliation: Interventional Radiology Department, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.|Interventional Radiology Department, University Paris - Sud, Kremlin Bicetre, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Deschamps
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed