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Journal of Zhejiang University-SCIENCE B

, Volume 19, Issue 11, pp 829–843 | Cite as

Radiofrequency ablation versus hepatic resection for breast cancer liver metastasis: a systematic review and meta-analysis

  • Yi-bin Xiao
  • Bo Zhang
  • Yu-lian Wu
Article
  • 1 Downloads

Abstract

Objective

To evaluate the comparative therapeutic efficacy of radiofrequency ablation (RFA) and hepatic resection (HR) for breast cancer liver metastases (BCLMs).

Methods

Studies that had examined the outcomes for both RFA and HR for BCLM were identified by searching the electronic databases PubMed, EMBASE, and the Cochrane Library. Pooled analyzes of the overall survival (OS), disease-free survival (DFS), and short-term outcomes of BCLM were performed.

Results

Patients with BCLM gained many more survival benefits from HR than from RFA with regard to the 3-year OS rate (combined odds ratio (OR) 0.41, 95% confidence interval (CI) 0.29–0.59, P<0.001), 5-year OS rate (combined OR 0.38, 95% CI 0.32–0.46, P<0.001), 3-year DFS (combined OR 0.36, 95% CI 0.27–0.49, P<0.001), and 5-year DFS (combined OR 0.51, 95% CI 0.40–0.66, P<0.001). RFA had fewer postoperative complications (combined OR 0.30, 95% CI 0.20–0.44, P<0.001) and shorter hospital stays (combined OR -9.01, 95% CI -13.49–4.54, P<0.001) than HR.

Conclusions

HR takes precedence over RFA in the treatment of patients with BCLM, considering the better survival rate. RFA gives rise to fewer complications and can be carried out with a shorter hospital stay, compared to HR. RFA should be reserved for patients who are not optimum candidates for resection.

Key words

Breast cancer liver metastasis Radiofrequency ablation Hepatic resection Prognosis Meta-analysis 

射频消融术与肝切除术治疗乳腺癌肝转移: 系统回顾和meta分析

中文概要

目的

评估射频消融术(RFA)和肝切除术(HR)治疗乳腺癌肝转移(BCLM)的效果。

创新点

首次采用meta分析的方法, 精确评估RFA和HR治疗BCLM的效果, 解决不同研究产生不同结论的矛盾。

方法

系统收集截止到2017年3月所有与RFA和HR治疗BCLM的效果相关文献, 评价文献质量、提取数据并计算癌症预后相关指标的优势比(OR)及其95%置信区间(CI)。

结论

HR比RFA对于提高BCLM患者生存率有更大优势RFA并发症少、可重复、患者术后住院时间短, 具有明显微创优势。对于不适合行切除治疗的患者可考虑行RFA治疗。

关键词

乳腺癌肝转移 肝切除术 射频消融 预后 Meta分析 

CLC number

R735.7 

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Notes

Acknowledgements

We thank all our colleagues from the Second Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China) for their help and support in this study.

References

  1. Abraham NS, Byrne CJ, Young JM, et al., 2010. Meta-analysis of well-designed nonrandomized comparative studies of surgical procedures is as good as randomized controlled trials. J Clin Epidemiol, 63(3):238–245. https://doi.org/10.1016/j.jclinepi.2009.04.005CrossRefGoogle Scholar
  2. Adam R, Aloia T, Krissat J, et al., 2006. Is liver resection justified for patients with hepatic metastases from breast cancer? Ann Surg, 244(6):897–908. https://doi.org/10.1097/01.sla.0000246847.02058.1bCrossRefGoogle Scholar
  3. Barral M, Auperin A, Hakime A, et al., 2016. Percutaneous thermal ablation of breast cancer metastases in oligometastatic patients. Cardiovasc Intervent Radiol, 39(6): 885–893. https://doi.org/10.1007/s00270-016-1301-xCrossRefGoogle Scholar
  4. Bortolotto C, Macchi S, Veronese L, et al., 2012. Radiofrequency ablation of metastatic lesions from breast cancer. J Ultrasound, 15(3):199–205. https://doi.org/10.1016/j.jus.2012.06.007CrossRefGoogle Scholar
  5. Bruners P, Schmitz-Rode T, Günther RW, et al., 2008. Multipolar hepatic radiofrequency ablation using up to six applicators: preliminary results. Rofo, 180(3):216–222. https://doi.org/10.1055/s-2008-1027184CrossRefGoogle Scholar
  6. Carrafiello G, Fontana F, Cotta E, et al., 2011. Ultrasoundguided thermal radiofrequency ablation (RFA) as an adjunct to systemic chemotherapy for breast cancer liver metastases. Radiol Med, 116(7):1059–1066. https://doi.org/10.1007/s11547-011-0697-2CrossRefGoogle Scholar
  7. Corona SP, Sobhani N, Ianza A, et al., 2017. Advances in systemic therapy for metastatic breast cancer: future perspectives. Med Oncol, 34(7):119. https://doi.org/10.1007/s12032-017-0975-5CrossRefGoogle Scholar
  8. Covey AM, Sofocleous CT, 2008. Radiofrequency ablation as a treatment strategy for liver metastases from breast cancer. Semin Intervent Radiol, 25(4):406–412. https://doi.org/10.1055/s-0028-1102996CrossRefGoogle Scholar
  9. Detry O, Warzee F, Polus M, et al., 2003. Liver resection for noncolorectal, nonneuroendocrine metastases. Acta Chir Belg, 103(5):458–462. https://doi.org/10.1080/00015458.2003.11679467CrossRefGoogle Scholar
  10. Frezza EE, Wachtel MS, 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(3):282–284. https://doi.org/10.1089/lap.2006.0100CrossRefGoogle Scholar
  11. Gillams AR, 2005. The use of radiofrequency in cancer. Br J Cancer, 92(10):1825–1829. https://doi.org/10.1038/sj.bjc.6602582CrossRefGoogle Scholar
  12. Golse N, Adam R, 2017. Liver metastases from breast cancer: what role for surgery? Indications and results. Clin Breast Cancer, 17(4):256–265. https://doi.org/10.1016/j.clbc.2016.12.012CrossRefGoogle Scholar
  13. Gunabushanam G, Sharma S, Thulkar S, et al., 2007. Radiofrequency ablation of liver metastases from breast cancer: results in 14 patients. J Vasc Interv Radiol, 18(1):67–72. https://doi.org/10.1016/j.jvir.2006.10.014CrossRefGoogle Scholar
  14. Illing R, Gillams A, 2010. Radiofrequency ablation in the treatment of breast cancer liver metastases. Clin Oncol (R Coll Radilo), 22(9):781–784. https://doi.org/10.1016/j.clon.2010.08.004CrossRefGoogle Scholar
  15. Keil S, Bruners P, Ohnsorge L, et al., 2010. Semiautomated versus manual evaluation of liver metastases treated by radiofrequency ablation. J Vasc Interv Radiol, 21(2):245–251. https://doi.org/10.1016/j.jvir.2009.10.024CrossRefGoogle Scholar
  16. Kim ES, Scott LJ, 2017. Palbociclib: a review in HR-positive, HER2-negative, advanced or metastatic breast cancer. Target Oncol, 12(3):373–383. https://doi.org/10.1007/s11523-017-0492-7CrossRefGoogle Scholar
  17. Kümler I, Parner VK, Tuxen MK, et al., 2015. Clinical outcome of percutaneous RFA-ablation of non-operable patients with liver metastasis from breast cancer. Radiol Med, 120(6):536–541. https://doi.org/10.1007/s11547-014-0489-6CrossRefGoogle Scholar
  18. Lai C, Jin RA, Liang X, et al., 2016. Comparison of laparoscopic hepatectomy, percutaneous radiofrequency ablation and open hepatectomy in the treatment of small hepatocellular carcinoma. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 17(3):236–246. https://doi.org/10.1631/jzus.B1500322CrossRefGoogle Scholar
  19. Lee HY, Ko HK, Kim SH, et al., 2013. Percutaneous radiofrequency ablation for liver metastases in breast cancer patients. Breast J, 19(5):563–565. https://doi.org/10.1111/tbj.12170CrossRefGoogle Scholar
  20. Livraghi T, Goldberg SN, Solbiati L, et al., 2001. Percutaneous radio-frequency ablation of liver metastases from breast cancer: initial experience in 24 patients. Radiology, 220(1):145–149. https://doi.org/10.1148/radiology.220.1.r01jl01145CrossRefGoogle Scholar
  21. Mansour M, Teo ZL, Luen SJ, et al., 2017. Advancing immunotherapy in metastatic breast cancer. Curr Treat Options Oncol, 18(6):35. https://doi.org/10.1007/s11864-017-0478-9CrossRefGoogle Scholar
  22. Meattini I, Desideri I, Francolini G, et al., 2017. Systemic therapies and cognitive impairment for breast cancer: an overview of the current literature. Med Oncol, 34(5):74. https://doi.org/10.1007/s12032-017-0935-0CrossRefGoogle Scholar
  23. 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(3):861–869. https://doi.org/10.1148/radiol.2533081968CrossRefGoogle Scholar
  24. Moher D, Liberati A, Tetzlaff J, et al., 2009. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 21:6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097Google Scholar
  25. Nordmann AJ, Kasenda B, Briel M, 2012. Meta-analyses: what they can and cannot do. Swiss Med Wkly, 142: w13518. https://doi.org/10.4414/smw.2012.13518Google Scholar
  26. Parmar MK, Torri V, Stewart L, 1998. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med, 17(24):2815–2834.CrossRefGoogle Scholar
  27. Ruiterkamp J, Ernst MF, 2011. The role of surgery in metastatic breast cancer. Eur J Cancer, 47(S3): S6–S22. https://doi.org/10.1016/S0959-8049(11)70142-3CrossRefGoogle Scholar
  28. Samaan NA, Buzdar AU, Aldinger KA, et al., 1981. Estrogen receptor: a prognostic factor in breast cancer. Cancer, 47(3):554–560.CrossRefGoogle Scholar
  29. Sato T, Sato S, Kato K, et al., 2006. Two cases of radiofrequency ablation (RFA) therapy for control of liver metastases from breast cancer. Jpn J Cancer Chemother, 33(12):1904–1906 (in Japanese).Google Scholar
  30. Selzner M, Morse MA, Vredenburgh JJ, et al., 2000. Liver metastases from breast cancer: long-term survival after curative resection. Surgery, 127(4):383–389. https://doi.org/10.1067/msy.2000.103883CrossRefGoogle Scholar
  31. Sofocleous CT, Nascimento RG, Gonen M, et al., 2007. Radiofrequency ablation in the management of liver metastases from breast cancer. Am J Roentgenol, 189(4): 883–889. https://doi.org/10.2214/AJR.07.2198CrossRefGoogle Scholar
  32. Stang A, 2010. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 25(9):603–605. https://doi.org/10.1007/s10654-010-9491-zCrossRefGoogle Scholar
  33. Travaini LL, Trifirò G, Ravasi L, et al., 2008. Role of [18F]FDG-PET/CT after radiofrequency ablation of liver metastases: preliminary results. Eur J Nucl Med Mol Imaging, 35(7):1316–1322. https://doi.org/10.1007/s00259-008-0748-7CrossRefGoogle Scholar
  34. Treska V, Liska V, Skalicky T, et al., 2012. Non-colorectal liver metastases: surgical treatment options. Hepatogastroenterology, 59(113):245–248. https://doi.org/10.5754/hge10292Google Scholar
  35. Treska V, Cerna M, Liska V, et al., 2014. Surgery for breast cancer liver metastases-factors determining results. Anticancer Res, 34(3):1281–1286.Google Scholar
  36. Veltri A, Gazzera C, Barrera M, et al., 2014. Radiofrequency thermal ablation (RFA) of hepatic metastases (METS) from breast cancer (BC): an adjunctive tool in the multimodal treatment of advanced disease. Radiol Med, 119(5):327–333. https://doi.org/10.1007/s11547-013-0354-zCrossRefGoogle Scholar
  37. Vogl TJ, Emam A, Naguib NN, et al., 2015. How effective are percutaneous liver-directed therapies in patients with non-colorectal liver metastases? Viszeralmedizin, 31(6): 406–413. https://doi.org/10.1159/000440677Google Scholar
  38. Wong J, Cooper A, 2016. Local ablation for solid tumor liver metastases: techniques and treatment efficacy. Cancer Control, 23(1):30–35. https://doi.org/10.1177/107327481602300106CrossRefGoogle Scholar
  39. Yun BL, Lee JM, Baek JH, et al., 2011. Radiofrequency ablation for treating liver metastases from a noncolorectal origin. Korean J Radiol, 12(5):579–587. https://doi.org/10.3348/kjr.2011.12.5.579CrossRefGoogle Scholar
  40. Zhang J, Liu Y, 2008. HER2 over-expression and response to different chemotherapy regimens in breast cancer. J Zhejiang Univ Sci B, 9(1):5–9. https://doi.org/10.1631/jzus.B073003CrossRefGoogle Scholar

Copyright information

© Zhejiang University and Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery, the Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina

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