Thermal ablation therapies in patients with breast cancer liver metastases: a review.
BACKGROUND
The liver is involved in about half of patients with metastatic breast cancer. Unfortunately systemic chemotherapy as the treatment of choice is limited. Due to multifocality and/or insufficient remnant liver volume, the majority of liver metastases are also unresectable. Currently, thermal ablations are used in these patients with acceptable impact.


METHODS
We reviewed studies on radiofrequency ablation (RFA), laser-induced thermotherapy (LITT) and microwave ablation (MWA) regarding local tumour response, progression and survival indexes in patients with breast cancer liver metastases (BCLM).


RESULTS
The reviewed literature showed positive response rates of 63 % to 97 % in RF-ablated lesions, 98.2 % in LITT-treated lesions and 34.5-62.5 % in MW-ablated lesions. Median survival was 10.9-60 months using RFA, 51-54 months after LITT and 41.8 months using MWA. Five-year survival rates were 27-30 %, 35 % and 29 %, respectively. Local tumour progression ranged from 13.5 % to 58 % using RFA, 2.9 % with LITT and 9.6 % with MWA.


CONCLUSIONS
The reviewed literature demonstrated that ablation therapies either as single therapy or combined with other locoregional therapies are a good alternative as an adjunction to resection in patients with resectable lesions or with positive response using chemotherapy. However, multicentre randomised studies should be conducted to obtain further evidence of the benefits of these treatments in patients with BCLM.
Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital, Theodor-Stern-Kei 7, 60590 Frankfurt am Main, Germany. T.Vogl@em.uni-frankfurt.de
Thomas J
TJ
Vogl
Parviz
P
Farshid
Nagy N N
NN
Naguib
Stephan
S
Zangos
D055011:Ablation Techniques / Q000401:mortality*; D001943:Breast Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000401:mortality*; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome