Radiofrequency ablation for the treatment of recurrent bone and soft-tissue sarcomas in non-surgical candidates

The aim of this study was to evaluate the safety and clinical utility of radiofrequency ablation (RFA) retrospectively in non-surgical candidates with recurrent bone and soft-tissue sarcomas.

Percutaneous RFA was used in 52 patients (21 female, 31 male; mean age, 52.2 ± 21.1 years; range 10–87 years) with recurrent bone and soft-tissue sarcomas. The number of tumors was 3 or fewer in 23 patients (44.2 %) and 4 or more in the others, with a mean maximum tumor diameter of 3.0 ± 3.7 cm (range 0.5–18 cm). Safety, tumor control, and prognosis were evaluated.

All tumors were ablated after RFA in 21 patients (40.4 %, 21/52), although 14 experienced re-recurrence. Tumors were controlled in 8 cases of recurrence by repeat RFA (n = 7) and surgical intervention (n = 1). Therefore, 15 patients (28.8 %, 15/52) were tumor-free at the end of follow-up (mean follow-up 25.5 ± 24.2 months; range 3.9–117 months). Residual tumors were found after RFA in the other 31 patients (59.6 %, 31/52). Overall survival rates were 73.4 % (95 % CI 61.0–85.9 %) at 1 year, 39.3 % (95 % CI 23.6–54.9 %) at 3 years, and 34.3 % (95 % CI 18.0–50.7 %) at 5 years in all patients. Recurrence-free interval (p = 0.040), tumor number (p = 0.0094), and complete tumor ablation (p < 0.0001) were detected as significant prognostic factors in univariate analysis. The latter two factors were significant in multivariate analysis. The rate of major complications was 0.9 %.

RFA is a safe and useful therapeutic option for treatment of recurrent bone and soft-tissue sarcomas. Prognostic factors found in this study will help to identify those patients who would benefit from RFA.