Cementoplasty of pelvic bone metastases: systematic assessment of lesion filling and other factors that could affect the clinical outcomes.

OBJECTIVES: To evaluate lesion filling and other factors that could affect the clinical outcomes of cementoplasty for pelvic bone metastases.

METHODS: We retrospectively reviewed the files of 40 patients treated for 44 pelvic bone metastases, collected the parameters related to patients (pain relief evaluated on a visual analog scale, subsequent fractures, and need for surgery), lesions (size, cortical breach score, fracture, soft-tissue extension), and cementoplasty procedures (number of needles, volume of cement, percentage of lesion filling, cement leaks, residual acetabular roof defect), and performed a statistical analysis.

RESULTS: The lesions were on average 43.2 mm in diameter and the mean cortical breach score was 2.5 out of 6, with a pathological fracture in 14 lesions. The number of needles inserted was one in 32 out of 44, two in 10 out of 44, and three in 2 out of 44. On average, the volume of cement injected per lesion was 10.3 ml and the filling was 54.8%. Mild or moderate asymptomatic cement leakage occurred in 20 lesions (45.5%). The mean pain score was 84.2 mm before the procedure (with no correlation with lesion size, cortical breach score or fracture) and 45.6 mm at follow-up. The pain relief of 38.6 mm was statistically significant (p < 0.001) and did not correlate with the filling percentage. There were no fractures of the treated lesions at a mean follow-up of 355 days.

CONCLUSIONS: Cementoplasty of pelvic bone metastases appears effective for providing pain relief and may prevent subsequent fractures. We were unable to demonstrate a correlation between the lesion filling and the degree of pain relief.