ECIO 2019 – MSK curative treatment

ECIO 2019 - MSK curative treatment

at the ICI i/o sessions this year there was much emphasis on treating of illegal metastatic disease which goes along with how msk interventional oncology has evolved from treating palliative lesions to treating for local cure and multiple sessions looked at the current literature on treating although metastatic lesions from sarcomas in particular in which we have a major role at the moment the most important things happening in emma skate humo treatment is the curative intent in illegal metastatic a bone disease if you look back ten years ago speaking about curative intent in this subgroup of patients who was like sailing in uncharted waters ever since the success of percutaneous ablation in other organs and pathologists a few brave guys started applying ablation in a ligament aesthetic patients with bone disease and they reported very high success rates equal with efficacy in other organs so the benefits are treating must have skeletal lesions with interventional oncology versus more traditional whether it be surgery radiation oncology is multifold one they can see on systemic therapy while we treat them two is that it's very minimally invasive three is that we can follow that with imaging and you know see how well we do local control and four patients don't have to stay in the hospital it's using a patient procedure traditionally illegal metastatic bone disease has been treated by surgery and radiation therapy surgery can be technically challenging technically morbid it is governed by higher complication rates and by prolong to recovery time and usually delay systemic therapy we can combine percutaneous ablation with fixation techniques of cement injection whenever necessary in the spine of the peripheral skeleton so when you're treating musculoskeletal lesions you know and you're gonna do ablation I think the biggest factor is the size of the lesion and its location two important structures the biggest thing is not necessarily where you're putting a pros but how you can stay out of trouble and take away somebody's motor strength to their you know lower extremity or upper extremities at present we have numerous ablation techniques in the market if we see the level of evidence in the literature we can say that we have to wait about IRA and high4 in order to provide curative intent and moment we do have cryoablation we do have a de frequency in microwave ablation the outcomes are more or less the same for all three techniques with very high success in efficacy rates in the near future we should be able to clearly establish criteria for performing percutaneous ablation in illegal metastatic bone disease furthermore we need to clearly define the timing of applying percutaneous ablation within a multidisciplinary input we need to have a strict follow-up strategy for all these patients and last but not least we need to define a therapeutic algorithm mainly for the peripheral skeleton and the next five to ten years as a musculoskeletal interventional oncology continue to increase in adoption as I said it's been a slow process but even at these meetings you can see the muscle skeletal sessions are much more attended than they were five to ten years ago and I also think you're gonna see it as part of those national or international guidelines and algorithms the treatment of both painful parasitic lesions as well as all ago metastatic lesions

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