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Percutaneous image guided thermal ablation safe, effective therapy for metastatic gynaecologic cancers

30 Mar 2021
Percutaneous image guided thermal ablation safe, effective therapy for metastatic gynaecologic cancers

A new study by researchers at the UCLA Jonsson Comprehensive Cancer Center found using percutaneous image guided needle based thermal ablation - the precise application of extreme heat or cold to a tumour using sophisticated ultrasound, CT or MRI in a single outpatient session - is a safe and effective adjunctive therapy for the local control of metastatic gynaecologic cancers throughout lungs, liver, soft tissues in the abdomen and pelvis and bones in patients with advanced localised cancers unresponsive to systemic therapy.

Nearly 96% of the patients in the study achieved a complete tumour response over a median follow up period of 10 months.

The overall survival rate was 37.5 months and the progression-free survival rate, the length of time their disease is controlled, was 16.5 months.

Less than 5% of patients experienced any major side effects.

Metastatic gynaecological cancers, including ovarian, endometrial or uterine and cervical, are often aggressive tumours with low survival rates.

Patients diagnosed with these cancers often undergo extensive and multiple surgeries as part of standard treatment.

However, surgery can be invasive and is not always feasible for patients with advanced cancers with localised nonresponsive tumours or patients who are not traditional surgical or radiation candidates.

One alternative option being studied is thermal ablation, which is an image-guided minimally-invasive needle-based approach that delivers highly accurate and precise localised treatment only to cancer cells while minimising the effects to surrounding tissue.

Thermal ablation was pioneered for liver, lung and kidney cancer, but it is currently being looked at to use in the care of other cancers, including prostate and gynaecological cancers.

Other benefits of thermal ablation are that it is an outpatient procedure, done with minimal sedation with lower risk and lower cost, in combination with systemic therapies, compared to traditional surgery or radiation.

For the study, Steven Raman, MD, professor of radiology, urology and surgery and a member of the UCLA Jonsson Comprehensive Cancer Center, led a multidisciplinary team of expert physicians to demonstrate the high safety and efficacy of percutaneous thermal ablation in targeting localised metastatic gynaecologic malignancies.

The study group included 42 women, ranging from 25 to 78 years old, with metastatic gynaecologic tumours (119 metastatic tumours) treated with radiofrequency (47 tumours), microwave (47 tumours) or cryogenic (30 tumours) ablation from over 2,800 ablations performed from January 2001 to January 2019.

This is the first and largest study to show that image guided needle based thermal ablation is a safe and effective approach for patients with localised metastatic gynaecologic cancers throughout the body, especially for those who cannot undergo additional surgery because of a declining health status or in areas previously radiated.

Source: University of California - Los Angeles Health Sciences