Combination of Percutaneous Cryoablation, Screw Fixation, and Cementoplasty for Painful Pelvic Bone Metastases: A Supportive Care Approach Improving Pain, Mobility, and Quality of Life.

PURPOSE: To evaluate the safety, feasibility, and early clinical outcomes of combined percutaneous cryoablation, screw fixation, and cementoplasty for painful pelvic bone metastases.

MATERIALS AND

METHODS

In this monocentric retrospective study, patients with painful pelvic bone metastases underwent percutaneous image-guided cryoablation followed by screw fixation and cementoplasty under computed tomography (CT) guidance. Technical success was defined as completion of all planned procedural steps without deviation. Clinical endpoints included adverse events, mobilization, discharge timing, pain, analgesic use, and quality of life. Imaging follow-up assessed screw stability, infection, local tumor behavior, and progression to joint replacement when applicable.

RESULTS

Seventeen patients were included. Technical success was achieved in all procedures. Cryoablation required a mean of 2.7 probes (SD ± 1.3), and 1.2 screws (SD ± 0.4) were implanted per procedure. Complete planned soft tissue ablation was achieved in 11 patients (64.7%), including complete combined bone and soft tissue ablation in 5 (29.4%); partial ablation/debulking was intentionally planned in the remaining 6 (35.3%). No periprocedural or early adverse events occurred. Thirteen patients (76.5%) were able to stand within 24 hours, and all within 4 days. Eight patients (47.1%) were discharged on postoperative Day 1, and 13 (76.5%) within 2 days. No patient required joint replacement during available follow-up. Median overall survival was approximately 150 days.

CONCLUSIONS

A combination of percutaneous cryoablation, screw fixation, and cementoplasty is feasible and safe and provides rapid early clinical benefit in selected patients with pelvic metastases. Larger comparative studies are required to confirm effectiveness and long-term joint-related outcomes.