Long-term outcomes of PET-guided Microwave Ablation of Breast Cancer Liver Metastases

Monday, March 6, 2023

3:54 PM – 4:03 PM

Location: Phoenix Convention Center, 221AB

Abstract Speaker(s)

Debkumar Sarkar, DO

Associate Attending
Memorial Sloan Kettering Cancer Center

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Constantinos T. Sofocleous, MD PhD

Professor IR
Weill Cornell Medical College Memorial Sloan-Kettering Cancer Center
Vlasios S. Sotirchos, MD

Assistant Attending
Memorial Sloan Kettering Cancer Center
EZ

Etay Ziv, MD PhD

Associate Attending
Memorial Sloan Kettering Cancer Center
Chenyang Zhan, MD PhD

Assistant Attending
Memorial Sloan Kettering Cancer Center
Yolanda Bryce, MD

Assistant Attending
Memorial Sloan Kettering Cancer Center
JE

Joseph P. Erinjeri, MD PhD

Attending
Memorial Sloan Kettering Cancer Center
SS

Stephen B. Solomon, MD

Section Chief
Memorial Sloan Kettering Cancer Center

Disclosure(s):

Debkumar Sarkar, DO: No financial relationships to disclose

Constantinos T. Sofocleous, MD PhD: No relevant disclosure to display

Vlasios S. Sotirchos, MD: No financial relationships to disclose

Etay Ziv, MD PhD: Ethicon J&J: Research Grant Recipient (Ongoing); Novartis Pharmaceuticals Corporation: Research Grant Recipient (Ongoing)

Yolanda Bryce, MD: Boston Scientific, Inc.: Speaking and Teaching (Terminated, March 31, 2022); Hologic, Inc: Consultant (Terminated, January 30, 2022); Pfizer: Speaking and Teaching (Terminated, November 30, 2022)

Stephen B. Solomon, MD: Aperture Medical: Board Membership (Ongoing), Consultant (Ongoing), Ownership Interest (Ongoing); Elesta: Research Grant Recipient (Ongoing); GE Healthcare: Consultant (Ongoing), Research Grant Recipient (Ongoing); Johnson & Johnson: Consultant (Ongoing), Ownership Interest (Ongoing); Microbot: Consultant (Ongoing); XAct Robotics: Consultant (Ongoing)

Purpose:

To assess the long-term outcomes of patients with breast cancer liver metastases treated with PET-guided microwave ablation and analyze variables affecting survival.

Materials and Methods:

This is an IRB approved retrospective review. From March 2012 to October 2017 a total of 20 patients (ages 39-83, mean 53.9years) with breast cancer liver metastases underwent FDG-18-PET guided microwave ablation using split dose technique. The number of lesions ranged from 1 to 3. Lesions ranged in size from 1.2-4.6cm. Margin assessment at time of ablation was performed using PET overlay. Independent variables assessed included number of lesions, lesion size > 3 cm, hormone receptor status, presence of margins >10mm, and presence of extrahepatic disease. Univariate analysis of overall survival (OS) was performed through Kaplan-Meier survival curves and log-rank tests.

Results:

Technical efficacy was 95% with complete metabolic response in 19 of 20 patients. Median OS was 46.3 months. 1, 3 and 5 year survival was 93%, 56% and 48% respectively. There was a statistically significant increase in OS when ablation margins were >10mm (63.9 months vs 23.8 months, p < 0.05). Other factors which significantly decreased OS were multiplicity of lesions (p = 0.05) and presence of extrahepatic disease ( p=0.028). Lesion size >3cm and hormone receptor status did not significantly impact OS.

Conclusion: PET guided microwave ablation of breast cancer liver metastases is most effective with a margin >10mm in patients with a solitary lesion and no extrahepatic disease. PET guidance may be an effective method for treating larger lesions >3cm compared to conventional image guided ablation techniques.