CT-Guided Radiofrequency Ablation in Patients with Hepatic Metastases from Breast Cancer

Abstract

The purpose of this study was to evaluate technical success, technique effectiveness, and survival following radiofrequency ablation for breast cancer liver metastases and to determine prognostic factors. Forty-three patients with 111 breast cancer liver metastases underwent CT-guided percutaneous radiofrequency (RF) ablation. Technical success and technique effectiveness was evaluated by performing serial CT scans. We assessed the prognostic value of hormone receptor status, overexpression of human epidermal growth factor receptor 2 (HER2), and presence of extrahepatic tumor spread. Survival rates were calculated using the Kaplan-Meier method. Technical success was achieved in 107 metastases (96%). Primary technique effectiveness was 96%. During follow-up local tumor progression was observed in 15 metastases, representing a secondary technique effectiveness of 86.5%. The overall time to progression to the liver was 10.5 months. The estimated overall median survival was 58.6 months. There was no significant difference in terms of survival probability with respect to hormone receptor status, HER2 overexpression, and presence of isolated bone metastases. Survival was significantly lower among patients with extrahepatic disease, with the exception of skeletal metastases. We conclude that CT-guided RF ablation of liver metastases from breast cancer can be performed with a high degree of technical success and technique effectiveness, providing promising survival rates in patients with no visceral extrahepatic disease. Solitary bone metastases did not negatively affect survival probability after RF ablation.

Liver resection and local ablation of breast cancer liver metastases – A systematic review

“…[47].The third largest study (N=43) showed similar figures, i.e. MOS 59 months; and 3-and 5-year survivals were 75% and 38%, respectively [48].…”

“…Thus, the annual average was 1 -23 treatments (median 2). Three institutions had an annual average exceeding four [43,47,48]. The rate of synchronous metastases were 0-19% (reported in 3/7 studies).…”

“…Various other EHD was accepted in 9 studies of liver resection, as long as EHD was resectable or stable on therapy [20,21,27,28,29,31,32,35,42], and in four studies of local ablation [45][46][47][48] (table 3).…”

Flat-Panel Cone-Beam Ct-Guided Radiofrequency Ablation of Very Small (≤1.5 cm) Liver Tumors: Technical Note on a Preliminary Experience

“…However, some cases may not be suitable for US guidance due to tumor invisibility, high risk of collateral thermal injury, or absence of a safe electrode path [2]. In such cases, CT is a valid alternative [3] even though it may be challenging especially for ''hard-to-reach'' lesions (i.e., lesions of the hepatic dome, very small lesions) due to lack of real-time guidance.…”

Radiofrequency ablation of metastatic lesions from breast cancer

“…The earliest and most frequent site of BC metastasis is the bones and lungs, and no more than 5%e20% of cases have only liver metastases [3]. Metastatic BC is worldwide considered a systemic disease and therefore treated with chemotherapy [4].…”