Riccardo Antonio Lencioni MD, Presenter: Nothing to Disclose

To determine the long-term results of percutaneous radiofrequency ablation (RFA) in the treatment of isolated hepatic metastases from breast cancer.

One hundred and two breast cancer patients (age range 33-78 years, mean age 53.8 years ± 12.1) with 153 hepatic metastases ranging 0.8-5 cm in diameter (mean, 2.4 cm ± 0.8) were treated with RFA at 12 centers. The centers were part of the tumor radiofrequency ablation Italian network (TRAIN) and adopted standardized diagnostic, staging, treatment, and follow-up protocols. All patients had either the liver as the sole site of metastatic disease (n = 91) or complete response of associated bone metastases (n = 11). Surgical option had been excluded or refused by the patient. RFA was performed under US or CT guidance by using 50- or 150-W generators and 14-G expandable multitined electrodes with 4-9 prongs (RITA Medical Systems, Mountain View, CA). Follow-up protocol included US and spiral CT examinations performed at 3 and 6-month intervals, respectively. The follow-up period ranged 1-64 months (mean, 18.7 months ± 15.5).

Complete tumor ablation was achieved in 93 (91.2%) of 102 patients after 121 treatment sessions. The primary effectiveness rate on a lesion-by-lesion basis was 86.9% (133 of 153 lesions). The overall survival by the Kaplan-Meier method was 95.2% at 1 year, 77.3% at 2 years, 49.6% at 3 years, 39.7% at 4 years, and 29.8% at 5 years. Median survival was 36 months. Analysis of proportional hazards by the whole model test showed that survival was significantly dependent on lesion size (p = 0.0062) and lesion multiplicity (p = 0.039). The 1-, 3-, and 5-year local tumor progression rates in a patient-by-patient analysis were 19.7%, 32.3%, and 32.3%, respectively. The 1-, 3-, and 5-year recurrence rates were 35.2%, 71.0%, and 85.0% for the emergence of new hepatic lesions; and 24.8%, 44.0%, and 65.0% for the development of extrahepatic disease.

RFA appears to be a viable complementary treatment method for selected patients with isolated breast cancer hepatic metastases.

Lencioni, R, Tumor Radiofrequency Ablation Italian Network (TRAIN): Survival Analysis in Breast Cancer Patients with Isolated Hepatic Metastases.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409323.html