Percutaneous Thermal Ablation of Breast Cancer Metastases in Oligometastatic Patients

• Published in: Cardiovascular and interventional radiology Vol. 39; no. 6; pp. 885 - 893
• Main Authors: Barral, M., Auperin, A., Hakime, A., Cartier, V., Tacher, V., Otmezguine, Yves, Tselikas, L., de Baere, T., Deschamps, F.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2016; Springer Nature B.V
• Subjects: ABLATION; Adult; Aged; Bone Neoplasms - pathology; Bone Neoplasms - secondary; Bone Neoplasms - surgery; Breast cancer; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Cardiology; CHEMOTHERAPY; Clinical Investigation; Combined Modality Therapy; CONTROL; Disease-Free Survival; Electrocoagulation - methods; Female; HORMONES; Humans; Imaging; LIVER; Liver Neoplasms - pathology; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Lung Neoplasms - pathology; Lung Neoplasms - secondary; Lung Neoplasms - surgery; LUNGS; MAMMARY GLANDS; Medicine; Medicine & Public Health; METASTASES; Middle Aged; MULTIVARIATE ANALYSIS; NEOPLASMS; Nuclear Medicine; PATIENTS; PHOSPHORUS 36; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Retrospective Studies; SKELETON; Survival Rate; Treatment Outcome; Ultrasound; Radiofrequency ablation; Microwave ablation; Breast neoplasms; Cryotherapy; Metastases
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-016-1301-x

Objective To evaluate prognostic factors associated with local control and disease-free-survival (DFS) of oligometastatic breast cancer patients treated by percutaneous thermal ablation (PTA). Materials and Methods Seventy-nine consecutive patients (54.5 ± 11.2 years old) with 114 breast cancer metastases (28.9 ± 16.1 mm in diameter), involving the lungs, the liver, and/or the bone, were treated using PTA with a curative intent. The goal was to achieve a complete remission in association with systemic chemotherapy and hormonal therapy. We retrospectively evaluated the prognostic factors associated with 1- and 2-year local control and the 1- and 2-year DFS rates. Results The 1- and 2-year local control rates were 83.0 and 76.1 %, respectively. Tumor burden was associated with a poorer outcome for local control after PTA (HR 1.027 by additional millimeter, p  = 0.026; >4 cm HR 3.90). The 1- and 2-year DFS rates were 54.2 and 30.4 %, respectively. In multivariate analysis, triple-negative histological subtype and increased size of treated metastases were associated with a poorer DFS (HR 2.22; 95 % CI [1.13–4.36]; p  = 0.02 and HR 2.43; 95 % CI [1.22–4.82]; p  = 0.011, respectively). Conclusion PTA is effective for local control of breast cancer oligometastases. Tumor burden >4 cm and triple-negative histological subtype are associated with a poorer outcome.