Analysis of the therapeutic effect of ultrasound-guided microwave ablation in the treatment of liver metastasis from breast cancer and the selection of beneficiaries
10.3760/cma.j.cn131148-20240717-00392
- VernacularTitle:超声引导下微波消融治疗乳腺癌肝转移的疗效评估及受益人群筛选
- Author:
Ran JI
1
;
Yuqing DAI
;
Qian CAI
;
Xiaopeng GAO
;
Wenzhen DING
;
Ping LIANG
;
Jie YU
Author Information
1. 解放军总医院第五医学中心介入超声科，北京 100853
- Publication Type:Journal Article
- Keywords:
Ultrasonography;
Microwave ablation;
Breast cancer;
Liver metastasis;
Nomogram
- From:
Chinese Journal of Ultrasonography
2024;33(12):1016-1022
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the therapeutic effect of ultrasound-guided microwave ablation (MWA) in the treatment of breast cancer liver metastases (BCLM), and to select the beneficiaries.Methods:A retrospective study was performed in 63 patients with BCLM who underwent ultrasound-guided microwave ablation in Department of Interventional Ultrasound, the Fifth Medical Center of Chinese PLA General Hospital, and had detailed follow-up data from February 2010 to October 2022. General patient data and laboratory results were collected. Univariate and multivariate Cox regression analyses were performed to determine the independent influencing factors for prognosis in patients with BCLM. A nomogram model was established to predict the survival rates of patients after operation.Calibration curve and decision curve were plotted to evaluate the calibration degree and the clinical benefit of the model, respectively. Time-dependent ROC curve was plotted to evaluate the predicting ability of the model. All patients were divided into high-risk group and low-risk group according to prognostic index. Survival curves were plotted to compare differences in survival between the two groups.Results:Multivariate Cox regression analysis showed that tumor burden score(TBS) and the presence of extrahepatic metastasis before MWA were independent influencing factors for prognosis of BCLM(all P<0.001). The combined prediction model was established based on TBS, extrahepatic metastasis and axillary nodal metastases. The areas under the 1-year, 2-year and 3-year ROC curves were 0.849, 0.855 and 0.878, respectively, suggesting that the model had good predicting ability. The calibration curve showed that the model had good calibration degree, while the decision curve showed that the model had good clinical practicability. The median survival time between the two groups was statistically significant[13.5 (9, 20) months vs 63.0 (39, 140) months, P<0.001]. Conclusions:Low-risk patients with BCLM gain significant clinical benefits after microwave ablation treatment, while high-risk patients do not exhibit a noticeable survival advantage.
