Locoregional Therapies for the Treatment of Hepatic Metastases from Breast and Gynecologic Cancers

Abstract

Breast cancer is the most common women's malignancy in the United States and is the second leading cause of cancer death. More than half of patients with breast cancer will develop hepatic metastases; this portends a poorer prognosis. In the appropriately selected patient, there does appear to be a role for curative (surgery, ablation) or palliative (intra-arterial treatments) locoregional therapy. Gynecologic malignancies are less common and metastases to the liver are most often seen in the setting of disseminated disease. The role of locoregional therapies in these patients is not well reported. The purpose of this article is to review the outcomes data of locoregional therapies in the treatment of hepatic metastases from breast and gynecologic malignancies.

Keywords

breast cancer - gynecologic malignancies - liver metastases - chemoembolization - radioembolization - interventional radiology

• References

• 1 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin 2017; 67 (01) 7-30
• 2 Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61 (02) 69-90
• 3 Zinser JW, Hortobagyi GN, Buzdar AU, Smith TL, Fraschini G. Clinical course of breast cancer patients with liver metastases. J Clin Oncol 1987; 5 (05) 773-782
• 4 Atalay G, Biganzoli L, Renard F. , et al; EORTC Breast Cancer and Early Clinical Studies Groups. Clinical outcome of breast cancer patients with liver metastases alone in the anthracycline-taxane era: a retrospective analysis of two prospective, randomised metastatic breast cancer trials. Eur J Cancer 2003; 39 (17) 2439-2449
• 5 Cummings MC, Simpson PT, Reid LE. , et al. Metastatic progression of breast cancer: insights from 50 years of autopsies. J Pathol 2014; 232 (01) 23-31
• 6 Chi DS, Fong Y, Venkatraman ES, Barakat RR. Hepatic resection for metastatic gynecologic carcinomas. Gynecol Oncol 1997; 66 (01) 45-51
• 7 Chi DS, Welshinger M, Venkatraman ES, Barakat RR. The role of surgical cytoreduction in Stage IV endometrial carcinoma. Gynecol Oncol 1997; 67 (01) 56-60
• 8 Kim GE, Lee SW, Suh CO. , et al. Hepatic metastases from carcinoma of the uterine cervix. Gynecol Oncol 1998; 70 (01) 56-60
• 9 Eklund JW, Trifilio S, Mulcahy MF. Chemotherapy dosing in the setting of liver dysfunction. Oncology (Williston Park) 2005; 19 (08) 1057-1063 , discussion 1063–1064, 1069
• 10 Field KM, Dow C, Michael M. Part I: Liver function in oncology: biochemistry and beyond. Lancet Oncol 2008; 9 (11) 1092-1101
• 11 Field KM, Michael M. Part II: Liver function in oncology: towards safer chemotherapy use. Lancet Oncol 2008; 9 (12) 1181-1190
• 12 Gradishar WJ, Anderson BO, Balassanian R. , et al. NCCN guidelines insights: breast cancer, version 1.2017. J Natl Compr Canc Netw 2017; 15 (04) 433-451
• 13 Golse N, Adam R. Liver metastases from breast cancer: what role for surgery? Indications and results. Clin Breast Cancer 2017; 17 (04) 256-265
• 14 Elsberger B, Roxburgh CS, Horgan PG. Is there a role for surgical resections of hepatic breast cancer metastases?. Hepatogastroenterology 2014; 61 (129) 181-186
• 15 Vogl TJ, Farshid P, Naguib NN, Zangos S. Thermal ablation therapies in patients with breast cancer liver metastases: a review. Eur Radiol 2013; 23 (03) 797-804
• 16 Livraghi T, Goldberg SN, Solbiati L, Meloni F, Ierace T, Gazelle GS. Percutaneous radio-frequency ablation of liver metastases from breast cancer: initial experience in 24 patients. Radiology 2001; 220 (01) 145-149
• 17 Lawes D, Chopada A, Gillams A, Lees W, Taylor I. Radiofrequency ablation (RFA) as a cytoreductive strategy for hepatic metastasis from breast cancer. Ann R Coll Surg Engl 2006; 88 (07) 639-642
• 18 Gunabushanam G, Sharma S, Thulkar S. , et al. Radiofrequency ablation of liver metastases from breast cancer: results in 14 patients. J Vasc Interv Radiol 2007; 18 (1, Pt 1): 67-72
• 19 Sofocleous CT, Nascimento RG, Gonen M. , et al. Radiofrequency ablation in the management of liver metastases from breast cancer. AJR Am J Roentgenol 2007; 189 (04) 883-889
• 20 Jakobs TF, Hoffmann RT, Schrader A. , et al. CT-guided radiofrequency ablation in patients with hepatic metastases from breast cancer. Cardiovasc Intervent Radiol 2009; 32 (01) 38-46
• 21 Meloni MF, Andreano A, Laeseke PF, Livraghi T, Sironi S, Lee Jr FT. Breast cancer liver metastases: US-guided percutaneous radiofrequency ablation–intermediate and long-term survival rates. Radiology 2009; 253 (03) 861-869
• 22 Carrafiello G, Fontana F, Cotta E. , et al. Ultrasound-guided thermal radiofrequency ablation (RFA) as an adjunct to systemic chemotherapy for breast cancer liver metastases. Radiol Med (Torino) 2011; 116 (07) 1059-1066
• 23 Lorentzen T, Skjoldbye BO, Nolsoe CP. Microwave ablation of liver metastases guided by contrast-enhanced ultrasound: experience with 125 metastases in 39 patients. Ultraschall Med 2011; 32 (05) 492-496
• 24 Liang P, Dong B, Yu X. , et al. Prognostic factors for percutaneous microwave coagulation therapy of hepatic metastases. AJR Am J Roentgenol 2003; 181 (05) 1319-1325
• 25 Hickey R, Mulcahy MF, Lewandowski RJ. , et al. Chemoradiation of hepatic malignancies: prospective, phase 1 study of full-dose capecitabine with escalating doses of yttrium-90 radioembolization. Int J Radiat Oncol Biol Phys 2014; 88 (05) 1025-1031
• 26 Gordon AC, Salem R, Lewandowski RJ. Yttrium-90 radioembolization for breast cancer liver metastases. J Vasc Interv Radiol 2016; 27 (09) 1316-1319
• 27 Lewandowski RJ, Geschwind JF, Liapi E, Salem R. Transcatheter intraarterial therapies: rationale and overview. Radiology 2011; 259 (03) 641-657
• 28 Salem R, Thurston KG. Radioembolization with 90yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 2: special topics. J Vasc Interv Radiol 2006; 17 (09) 1425-1439
• 29 Salem R, Thurston KG. Radioembolization with 90Yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 1: Technical and methodologic considerations. J Vasc Interv Radiol 2006; 17 (08) 1251-1278
• 30 Lewandowski RJ, Sato KT, Atassi B. , et al. Radioembolization with 90Y microspheres: angiographic and technical considerations. Cardiovasc Intervent Radiol 2007; 30 (04) 571-592
• 31 Ang C, Jhaveri K, Patel D, Gewirtz A, Seidman A, Kemeny N. Hepatic arterial infusion and systemic chemotherapy for breast cancer liver metastases. Breast J 2013; 19 (01) 96-99
• 32 Arai Y, Sone Y, Inaba Y, Ariyoshi Y, Kido C. Hepatic arterial infusion chemotherapy for liver metastases from breast cancer. Cancer Chemother Pharmacol 1994; 33 (Suppl): S142-S144
• 33 Nielsen DL, Nørgaard H, Vestermark LW. , et al. Intrahepatic and systemic therapy with oxaliplatin combined with capecitabine in patients with hepatic metastases from breast cancer. Breast 2012; 21 (04) 556-561
• 34 Vogl TJ, Naguib NNN, Nour-Eldin N-EA, Eichler K, Zangos S, Gruber-Rouh T. Transarterial chemoembolization (TACE) with mitomycin C and gemcitabine for liver metastases in breast cancer. Eur Radiol 2010; 20 (01) 173-180
• 35 Vogl TJ, Naguib NN, Nour-Eldin NE. , et al. Repeated chemoembolization followed by laser-induced thermotherapy for liver metastasis of breast cancer. AJR Am J Roentgenol 2011; 196 (01) W66-72
• 36 Eichler K, Jakobi S, Gruber-Rouh T, Hammerstingl R, Vogl TJ, Zangos S. Transarterial chemoembolisation (TACE) with gemcitabine: phase II study in patients with liver metastases of breast cancer. Eur J Radiol 2013; 82 (12) e816-e822
• 37 Cho SW, Kitisin K, Buck D. , et al. Transcatheter arterial chemoembolization is a feasible palliative locoregional therapy for breast cancer liver metastases. Int J Surg Oncol 2010; 2010: 251621
• 38 Martin RCG, Robbins K, Fagés JF. , et al. Optimal outcomes for liver-dominant metastatic breast cancer with transarterial chemoembolization with drug-eluting beads loaded with doxorubicin. Breast Cancer Res Treat 2012; 132 (02) 753-763
• 39 Lin Y-T, Médioni J, Amouyal G, Déan C, Sapoval M, Pellerin O. Doxorubicin-loaded 70-150 μm microspheres for liver-dominant metastatic breast cancer: results and outcomes of a pilot study. Cardiovasc Intervent Radiol 2017; 40 (01) 81-89
• 40 Haug AR, Tiega Donfack BP, Trumm C. , et al. 18F-FDG PET/CT predicts survival after radioembolization of hepatic metastases from breast cancer. J Nucl Med 2012; 53 (03) 371-377
• 41 Cianni R, Pelle G, Notarianni E. , et al. Radioembolisation with (90)Y-labelled resin microspheres in the treatment of liver metastasis from breast cancer. Eur Radiol 2013; 23 (01) 182-189
• 42 Jakobs TF, Hoffmann R-T, Fischer T. , et al. Radioembolization in patients with hepatic metastases from breast cancer. J Vasc Interv Radiol 2008; 19 (05) 683-690
• 43 Saxena A, Kapoor J, Meteling B, Morris DL, Bester L. Yttrium-90 radioembolization for unresectable, chemoresistant breast cancer liver metastases: a large single-center experience of 40 patients. Ann Surg Oncol 2014; 21 (04) 1296-1303
• 44 Gordon AC, Gradishar WJ, Kaklamani VG. , et al. Yttrium-90 radioembolization stops progression of targeted breast cancer liver metastases after failed chemotherapy. J Vasc Interv Radiol 2014; 25 (10) 1523-1532 , 1532.e1–1532.e2
• 45 Fendler WP, Lechner H, Todica A. , et al. Safety, efficacy, and prognostic factors after radioembolization of hepatic metastases from breast cancer: a large single-center experience in 81 patients. J Nucl Med 2016; 57 (04) 517-523
• 46 Pieper CC, Meyer C, Wilhelm KE. , et al. Yttrium-90 radioembolization of advanced, unresectable breast cancer liver metastases—a single-center experience. J Vasc Interv Radiol 2016; 27 (09) 1305-1315
• 47 Forstner R. Radiological staging of ovarian cancer: imaging findings and contribution of CT and MRI. Eur Radiol 2007; 17 (12) 3223-3235
• 48 Aletti GD, Podratz KC, Cliby WA, Gostout BS. Stage IV ovarian cancer: disease site-specific rationale for postoperative treatment. Gynecol Oncol 2009; 112 (01) 22-27
• 49 Cormio G, Rossi C, Cazzolla A. , et al. Distant metastases in ovarian carcinoma. Int J Gynecol Cancer 2003; 13 (02) 125-129
• 50 Tangjitgamol S, Levenback CF, Beller U, Kavanagh JJ. Role of surgical resection for lung, liver, and central nervous system metastases in patients with gynecological cancer: a literature review. Int J Gynecol Cancer 2004; 14 (03) 399-422
• 51 Kurra V, Krajewski KM, Jagannathan J, Giardino A, Berlin S, Ramaiya N. Typical and atypical metastatic sites of recurrent endometrial carcinoma. Cancer Imaging 2013; 13 (01) 113-122
• 52 Lim MC, Kang S, Lee KS. , et al. The clinical significance of hepatic parenchymal metastasis in patients with primary epithelial ovarian cancer. Gynecol Oncol 2009; 112 (01) 28-34
• 53 Bosquet JG, Merideth MA, Podratz KC, Nagorney DM. Hepatic resection for metachronous metastases from ovarian carcinoma. HPB 2006; 8 (02) 93-96
• 54 Merideth MA, Cliby WA, Keeney GL, Lesnick TG, Nagorney DM, Podratz KC. Hepatic resection for metachronous metastases from ovarian carcinoma. Gynecol Oncol 2003; 89 (01) 16-21
• 55 Liu PC, Benjamin I, Morgan MA, King SA, Mikuta JJ, Rubin SC. Effect of surgical debulking on survival in stage IV ovarian cancer. Gynecol Oncol 1997; 64 (01) 4-8
• 56 Vogl TJ, Naguib NN, Lehnert T. , et al. Initial experience with repetitive transarterial chemoembolization (TACE) as a third line treatment of ovarian cancer metastasis to the liver: indications, outcomes and role in patient's management. Gynecol Oncol 2012; 124 (02) 225-229
• 57 Sato KT, Lewandowski RJ, Mulcahy MF. , et al. Unresectable chemorefractory liver metastases: radioembolization with 90Y microspheres–safety, efficacy, and survival. Radiology 2008; 247 (02) 507-515