Thermal ablation of metastatic disease to the musculoskeletal system

A variety of indications have been published regarding the use of percutaneous thermal ablation for treating tumors of the musculoskeletal system, including bone and soft tissue lesions, benign and malignant lesions, and primary and metastatic tumors. In the appropriately selected patient, the advantages of percutaneous thermal ablation include decreased morbidity, decreased cost, and shorter hospitalization stays compared to surgery. The number of different thermal ablation modalities is increasing, and each modality has its advantages and disadvantages. Studies directly comparing the effectiveness of the various thermal ablation modalities are sparse, however, so the choice of ablation modality often depends on availability, user preference, and local expertise. Although the list of uses for percutaneous thermal ablation is ever-expanding, in this article, we will discuss the two most well-established indications, which are palliation of pain attributed to bone and soft tissue metastases and local control of oligometastatic disease. Numerous clinical trials have shown percutaneous thermal ablation to be an effective method of palliating pain due to bone and soft tissue metastases and of achieving local control in the setting of oligometastatic disease with low rates of complication.