Percutaneous Cryoablation for Sternal Bone Metastases: A Retrospective Study

Sternal metastases are uncommon and challenging to treat with ablation due to adjacent mediastinal structures and severe pain. This retrospective study conducted between 2017 and 2025 reviewed 14 patients (10 females and 4 males; mean age, 62 years; range, 39-79 years) treated with percutaneous cryoablation, which offers a less invasive option for palliation. Primary tumors included breast (n = 9), lung (n = 3), renal cell carcinoma (n = 1), and myxoid liposarcoma (n = 1). Twelve patients underwent palliative cryoablation, and 2 were treated with curative intent. Procedures were performed with cone-beam computed tomography (CT) or CT guidance with ultrasound (US) assistance. Pain (numeric rating scale [NRS] and visual analog scale [VAS]) and imaging-based local control were assessed at baseline and 3 months. Thirteen patients (93%) reported significant pain reduction: mean NRS score from 7.31 (SD ± 0.95) to 3.15 (SD ± 1.52) (P < .000001) and mean VAS score from 6.64 (SD ± 1.65) to 3.21 (SD ± 1.37) (P < .000001). Local control was achieved in both curative cases. Percutaneous cryoablation appears safe and effective for palliation of sternal metastases and merits further evaluation.