Franca Meloni MD, Presenter: Nothing to Disclose

Anita Andreano MD, Abstract Co-Author: Nothing to Disclose

Paul F. Laeseke PhD, Abstract Co-Author: Stockholder, NeuWave Medical Inc, Madison, WI Consultant, NeuWave Medical Inc, Madison, WI

Sandro Sironi MD, Abstract Co-Author: Nothing to Disclose

Carmine Tinelli MD, MSC, Abstract Co-Author: Nothing to Disclose

Tito Livraghi MD, Abstract Co-Author: Nothing to Disclose

Metastatic breast cancer is associated with a dismal prognosis, even with standard treatment. Recent studies demonstrated increased survival for selected patients undergoing resection or laser ablation of liver metastases (mean survival 15-63 months). The aim of our study was to retrospectively assess the intermediate and long-term survival rates of patients with breast cancer liver metastases treated with percutaneous ultrasound-guided RF ablation (RFA).

RFA was used to treat 52 patients (median age, 55 years) with 87 breast cancer liver metastases (mean diameter 2.5 cm). Inclusion criteria were: less than 5 tumors, maximum tumor diameter of 5 cm, disease either confined to the liver (48%) or stable on medical therapy (52%). Ninety-two percent of patients had been treated before RFA with chemotherapy and/or hormonotheraphy with either no or incomplete response. RFAs were performed using either general anesthesia (47 patients) or conscious sedation (5 patients). Contrast-enhanced CT and contrast-enhanced ultrasound (the latter after 2002) were performed the day after the procedure to evaluate complications and technical success as well as at 1 month and every 3-4 months thereafter. The Kaplan-Meier method and Cox regression were used to assess survival; groups were compared with the log-rank test.

Radiological complete tumor necrosis was achieved in 96.5% (84/87) of tumors. One major complication occurred—an infarct of the left lobe of the liver (1.9%). Five of 52 patients (9.6%) developed pleural effusions. One patient did not come back for follow-up. Mean and median time of follow-up were 32.6 and 19.1 months (range, 2.9–110.3 months), respectively. Local tumor progression occurred in 13/51(25.5%) patients. New intrahepatic metastases developed in 27/51 (52.9%) patients. Overall median survival time was 29.9 months. The 1, 3 and 5-year survival rate were 67.8 %, 42.7 % and 26.7%. Median survival time in the subgroup of 31 patients that had at least 5 year follow-up was 32.5 months. Patients with tumors larger than 2.5 cm had a worse prognosis (hazard ratio, 2.7).

Survival rates in selected patients with breast liver metastasis treated with RFA are comparable to those obtained with surgery or laser ablation reported in the literature.

RF ablation should be considered part of multimodality therapy for patients with breast cancer liver metastases.

Meloni, F, Andreano, A, Laeseke, P, Sironi, S, Tinelli, C, Livraghi, T, Patients with Breast Liver Metastasis Treated with Percutaneous Radiofrequency Ablation: Intermediate and Long-term Survival Rates.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6018527.html