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La radiologia medica

, Volume 116, Issue 7, pp 1059–1066 | Cite as

Ultrasound-guided thermal radiofrequency ablation (RFA) as an adjunct to systemic chemotherapy for breast cancer liver metastases

  • G. CarrafielloEmail author
  • F. Fontana
  • E. Cotta
  • M. Petullà
  • L. Brunese
  • M. Mangini
  • C. Fugazzola
Abdominal Radiology / Radiologia Addominale

Abstract

Purpose

The aim of this study was to evaluate the effectiveness of radiofrequency thermal ablation (RFA) of liver metastases from breast cancer and its impact on survival.

Materials and methods

Thirteen female patients (age range 36–82 years; median 54.5 years) underwent RFA for the treatment of 21 liver metastases from breast cancer. The procedures were performed under ultrasound (US) guidance using an RF 2000 or RF 3000 generator system and Le Veen monopolar needle electrodes. Follow-up was carried out by computed tomography (CT) after 1, 3, 6 and 12 months.

Results

Technical success was 100%. No major or minor complications occurred at the end of the procedure. In our series, 7/21 lesions in 7/13 patients increased in size at 7, 18, 19 and 38 months. This resulted in a mean disease-free interval of 16.6 months. Mean overall survival after RFA was 10.9 months.

Conclusions

RFA appears to be a useful adjunct to systemic chemotherapy and/or hormone therapy in the locoregional treatment of hepatic metastases from breast cancer. RFA may also be a less invasive alternative to surgery in the locoregional treatment of liver metastases from breast cancer

Keywords

Radiofrequency thermal ablation (RFA) Breast cancer metastasis 

Termoablazione epatica con radiofrequenza (RFA) sotto guida ecografica come trattamento aggiuntivo alla chemioterapia nel tumore della mammella metastatico

Riassunto

Obiettivo

Scopo di questo studio è valutare l’efficacia della termoablazione con radiofrequenza (RFA) nel trattamento delle metastasi epatiche da tumore della mammella e il suo impatto sulla sopravvivenza.

Materiali e metodi

Tredici pazienti (range 36–82 anni, età media 54,5 anni) sono state sottoposte a RFA di 21 metastasi epatiche da carcinoma della mammella. La procedura è stata eseguita utilizzando generatori RF 2000 o RF 3000 e sistema di aghi-elettrodi Le Veen monopolari. I controlli sono stati effettuati mediante tomografia computerizzata (TC) a 1, 3, 6, 9 e 12 mesi dopo la procedura.

Risultati

È stato ottenuto un successo tecnico del 100%. Non si sono verificate complicanze peri- e postprocedurali. Nella nostra serie 7/21 lesioni in 7/13 pazienti sono aumentate dimensionalmente a 7, 18, 19 e a 38 mesi. L’intervallo libero da malattia è stato di 16,6 mesi. La media di sopravvivenza dopo radiofrequenza è stata di 10,9 mesi.

Conclusioni

La RFA con effetto citoriduttivo, in pazienti con tumore della mammella rappresenta un’efficace metodica di trattamento, in aggiunta alla chemioterapia sistemica e all’ormonoterapia, delle metastasi epatiche. RFA rappresenta una valida alternativa alla chirurgia nel trattamento loco-regionale delle metastasi da tumore mammario.

Parole chiave

Termoablazione con radiofrequenza (RFA) Tumore della mammella metastatico 

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References/Bibliografia

  1. 1.
    Smith IE (1987) Recurrent disease. In: Harris JR, Hellman S, Henderson IC, Kinne DW (eds) Breast diseases. Lippincott, Philadelphia, pp 369–384Google Scholar
  2. 2.
    Hoe AL, Royle GT, Taylor I (1991) Breast liver metastases — incidence diagnosis and outcome. J R Soc Med 84:714–716PubMedGoogle Scholar
  3. 3.
    Wyld L, Gutteridge E, Pinder SE et al (2003) Prognostic factors for patient with hepatic metastases from breast cancer. Br J Cancer 89:284–290PubMedCrossRefGoogle Scholar
  4. 4.
    Kemeny N (1983) The systemic chemotherapy of hepatic metastases. In: Garnick MB (ed) Seminars in oncology. Grune & Stratton, New York, pp 148–155Google Scholar
  5. 5.
    Scheneebaum S, Walker M, Young D et al (1994) The regional treatment of liver metastases from breast cancer. J Surg Onc 55:26–32CrossRefGoogle Scholar
  6. 6.
    Zinser JW, Hortobagyi GN, Buzdar AU et al (1987) Clinical course of breast cancer patients with liver metastases. J Clin Oncol 5:773–782PubMedGoogle Scholar
  7. 7.
    Curley SA, Izzo F, Delrio P et al (1999) Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg 230:1–8PubMedCrossRefGoogle Scholar
  8. 8.
    Machi J (2001) Radiofrequency ablation for multiple hepatic metastases (2001) Ann Surg Oncol 8:379–380PubMedCrossRefGoogle Scholar
  9. 9.
    DeMatteo RP, Shah A, Fong Y et al (2001) Results of hepatic resection for sarcoma metastatic to liver. Ann Surg 234:540–547PubMedCrossRefGoogle Scholar
  10. 10.
    Di Carlo I, Grasso G, Patane D et al (2003) Liver metastases from lung cancer: is surgical resection justified? Ann Thorac Surg 76:291–293PubMedCrossRefGoogle Scholar
  11. 11.
    Laganà D, Carrafiello G, Mangini M et al (2008) Hepatic radiofrequency under CT-fluoroscopy guidance. Radiol Med 113:87–100PubMedCrossRefGoogle Scholar
  12. 12.
    Choi H, Loyer EM, DuBrow RA et al (2001) Radio-frequency ablation of liver tumors: assessment of therapeutic response and complications. RadioGraphics 21:S41–S54PubMedGoogle Scholar
  13. 13.
    Livraghi T, Goldberg SN, Solbiati G et al (2001) Percutaneous radio-frequency ablation of liver metastases from breast cancer: initial experience in 24 patients. Radiology 220:145–149PubMedGoogle Scholar
  14. 14.
    Gunabushanam G, Sharma S, Thulkar et al (2007) Radiofrequency ablation of liver metastases from breast cancer: results in 14 patients. J Vasc Interv Radiol 18:64–72CrossRefGoogle Scholar
  15. 15.
    Lawes D, Chopada A, Gillams A et al (2006) Radiofrequency ablation (RFA) as a cytoreductive strategy for hepatic metastasis from breast cancer. Ann R Coll Surg Engl 88:639–642PubMedCrossRefGoogle Scholar
  16. 16.
    Giordano SH, Buzdar AU, Smith TL et al (2004) Is breast cancer survival improving? Trends in survival for patients with recurrent breast cancer diagnosed from 1974 through 2000. Cancer 100:44–52PubMedCrossRefGoogle Scholar
  17. 17.
    Diaz R, Santaballa A, Munarriz B et al (2004) Hepatic resection in breast cancer metastases: should it be considered standard treatment? Breast 13:254–258PubMedCrossRefGoogle Scholar
  18. 18.
    Gillams AR (2005) The use of radiofrequency in cancer. Br J Cancer 92:1925–1929CrossRefGoogle Scholar
  19. 19.
    Lencioni R (2004) Tumor Radiofrequency Ablation Italian Network (TRAIN): survival analysis in breast cancer patients with isolated hepatic metastases. Scientific Assembly of the Radiological Society of North America, 2004, Chicago, ILGoogle Scholar
  20. 20.
    Sofocleus CT, Nascimento RG, Gonen M et al (2007) Radiofrequency ablation in the management of liver metastases from breast cancer. AJR Am J Roentgenol 189:883–889CrossRefGoogle Scholar
  21. 21.
    Meloni MF, Andreano A, Laeseke PF et al (2009) Breast cancer liver metastases: US-guided percutaneous radiofrequency ablation—intermediate and long-term survival rates. Radiology 253:861–869PubMedCrossRefGoogle Scholar
  22. 22.
    Jakobs TF, Hoffmann RT, Schrader A et al (2009) CT-guided radiofrequency ablation in patients with hepatic metastases from breast cancer. Cardiovasc Intervent Radiol 32:38–46PubMedCrossRefGoogle Scholar
  23. 23.
    Lencioni R, Goletti O, Armillotta N (1998) Radiofrequency thermal ablation of liver metastases with cooled-tip electrode needle: results of a pilot clinical trial. Eur Radiol 8:1205–1211PubMedCrossRefGoogle Scholar
  24. 24.
    Rossi S, Di Stasi M, Buscarini E et al (1998) Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR Am J Roentgenol 170:1015–1022PubMedGoogle Scholar
  25. 25.
    Solbiati G, Goldberg SN, Ierace T et al (1997) Hepatic metastases: percutaneous radiofrequency ablation with cooled tip electrodes. Radiology 205:367–373PubMedGoogle Scholar
  26. 26.
    Frezza E, Watchtel M, Barragan B et al (2007) The role of radiofrequency ablation in multiple liver metastases to debulk the tumor: a pilot study before alternative therapies. J Laparoendosc Adv Surg Tech A 17:282–284PubMedCrossRefGoogle Scholar
  27. 27.
    Pocard M, Pouillart P, Asselain B et al (2000) Hepatic resection in metastatic breast cancer: results and prognostic factors. Eur J Surg Oncol 26:155–159PubMedCrossRefGoogle Scholar
  28. 28.
    Vlastos G, Smith DL, Singletary E et al (2004) Long-term survival after an aggressive surgical approach in patients with breast cancer hepatic metastases. Ann Surg Oncol 11:869–874PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • G. Carrafiello
    • 1
    Email author
  • F. Fontana
    • 1
  • E. Cotta
    • 1
  • M. Petullà
    • 1
  • L. Brunese
    • 2
  • M. Mangini
    • 1
  • C. Fugazzola
    • 1
  1. 1.Dipartimento di Diagnostica per Immagini, Ospedale di Circolo Fondazione MacchiUniversità dell’InsubriaVareseItaly
  2. 2.Cattedra di Radiologia, Dipartimento di Scienze per la SaluteUniversità del MoliseCampobassoItaly

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