979 Radiofrequency Ablation a Novel Method in Radical Oncological Treatment of Spinal Oligometastatic Disease
P Saha, E Tsang, Z Hwang, B Ajayi, P Minhas, D Lui- Surgery
Abstract
Aim
Radiofrequency Ablation (RFA) is a curative novel addition to the armamentarium of radical oncological treatment. RFA as an adjunct to separation surgery may be a new technique that may have a beneficial compound effect of cytoreduction. The novel use of RFA in conjunction to radical treatment or independently for the treatment of oligometastatic disease (OMD) is investigated at a quaternary level 1 spinal center.
Method
Retrospective review of spinal OMD patients between 01/01/2017-01/12/2022. Patient demographic data, tumour histology, OMD type, surgery type and instrumentation, RFA, local recurrence (LR), infection and mortality data were analysed.
Results
15 cases of RFA. 11 out 26 separation surgeries (SS) performed for patients in the OMD/OPD pathway had adjunct RFA ± cement. Titanium SS with RFA ± cement (n = 4): 2-year LC– 0%; 2 years mortality–0% Titanium separation surgery without RFA ± cement (n = 16)–1 year LC–6% (n = 1); 30-day mortality – 12.5% There were 7 cases with independent RFA and cement, 1 case with RFA + biopsy and 3 cases with cement only. LR–0% at 6 months(n = 9), 12 months (n = 7) and 24 months (n = 5), the pain was well managed, no infection, and mortality–0% at 6 months(n = 11), 12 months (n = 7) and 24 months (n = 5).
Conclusions
RFA is promising for OMD pathway which can potentially deliver radical oncological control. As an adjunct to SS and SABR, it may offer improved cytoreductive control. The authors believe they are the first to describe this technique used in conjunction with SS where we show local recurrence of 0% at 2 years.