The Addition of Radiofrequency Tumor Ablation to Kyphoplasty May Reduce the Rate of Local Recurrence in Spinal Metastases Secondary to Breast Cancer.
BACKGROUND: Approximately 10% of all cancer patients develop spinal metastases. When a symptomatic compression fracture occurs without associated deformity or neurologic deficit, it can be treated with kyphoplasty with or without radiofrequency ablation (RFA). Treatment with kyphoplasty is well established but does not address the underlying oncologic disease.
METHODS: Retrospective medical chart analysis of breast cancer patients (n = 23) with metastatic spinal fractures (n = 50 vertebral levels) who underwent RFA and kyphoplasty was undertaken. Key variables of interest included: fracture location, pain levels, and local recurrence. Local recurrence data were compared to published rates of recurrence in breast cancer-related metastatic spinal fractures treated with vertebroplasty or kyphoplasty alone. Data were analyzed using χ
RESULTS: The mean preoperative pain level for this cohort was 6.9 on a 10-point visual analogue scale. Significant reductions in pain levels were observed postoperatively, at discharge (3.5; P < 0.05), at 1-month follow-up (2.8; P < 0.05), at 3-month follow-up (1.1; P < 0.05), and at 6-month follow-up (0.7 P < 0.05). Compared with published data of breast cancer patients with metastatic spinal fractures treated with vertebroplasty or kyphoplasty alone, the addition of RFA resulted in reduced local tumor recurrence (2% vs. 14%; P < 0.05). Average length of follow-up was 39 months.
CONCLUSIONS: The results suggest that the addition of RFA to kyphoplasty may reduce local tumor recurrence while providing similar pain relief benefits. The extrapolation of this added benefit to metastases from other primary cancers should be examined in future studies.