Breast cancer liver metastases: US-guided percutaneous radiofrequency ablation--intermediate and long-term survival rates.
OBJECTIVE
To retrospectively assess the local control and intermediate- and long-term survival of patients with liver metastases from breast cancer who have undergone percutaneous ultrasonography (US)-guided radiofrequency (RF) ablation.


METHODS
This study was approved by the hospital ethics committee, and all patients provided written informed consent. RF ablation was used to treat 87 breast cancer liver metastases (mean diameter, 2.5 cm) in 52 female patients (median age, 55 years). Inclusion criteria were as follows: fewer than five tumors, maximum tumor diameter of 5 cm or smaller, and disease either confined to the liver or stable with medical therapy. Forty-five (90%) of 50 patients had previously undergone chemotherapy, hormonal therapy, or both, and had no response or an incomplete response to the treatment. Contrast material-enhanced computed tomography and US were performed to evaluate complications and technical success and to assess for local tumor progression during follow-up. The Kaplan-Meier method was used to assess survival, and results were compared between groups with a log-rank test. Cox regression analysis was used to assess independent prognostic factors that affected survival.


RESULTS
Complete tumor necrosis was achieved in 97% of tumors. Two (4%) minor complications occurred. Median time to follow-up from diagnosis of liver metastasis and from RF ablation was 37.2 and 19.1 months, respectively. Local tumor progression occurred in 25% of patients. New intrahepatic metastases developed in 53% of patients. From the time of first RF ablation, overall median survival time and 5-year survival rate were 29.9 months and 27%, respectively. From the time the first liver metastasis was diagnosed, overall median survival time was 42 months, and the 5-year survival rate was 32%. Patients with tumors 2.5 cm in diameter or larger had a worse prognosis (hazard ratio, 2.1) than did patients with tumors smaller than 2.5 cm in diameter.


CONCLUSIONS
Survival rates in selected patients with breast cancer liver metastases treated with RF ablation are comparable to those reported in the literature that were achieved with surgery or laser ablation.
Meloni
Maria Franca
MF
Department of Radiology, Ospedale Civile di Vimercate, Via Cesare Battisti 23, Vimercate, 20059 Milan, Italy. francameloni@yahoo.it
Andreano
Anita
A
Laeseke
Paul F
PF
Livraghi
Tito
T
Sironi
Sandro
S
Lee
Fred T
FT
D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D017115:Catheter Ablation; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D006801:Humans; D007479:Iopamidol; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D010743:Phospholipids; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride; D015996:Survival Rate; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D007479:Iopamidol; D013459:Sulfur Hexafluoride