Efficacy and Safety of Radiofrequency Ablation for Breast Cancer Smaller Than 2 cm: A Systematic Review and Meta-Analysis

BackgroundTo evaluate the efficacy and safety of radiofrequency ablation (RFA) of breast cancer smaller than 2 cm.MethodsA systematic search was conducted in the PubMed and EMBASE databases to identify published studies investigating the efficacy and safety of RFA for breast cancer smaller than 2 cm. The main outcomes were technical success rate of the ablation, complete ablation rate, complications and local recurrence. Secondary considerations were mode of anesthesia, pain tolerance, mean ablation time and surgical excision after ablation.ResultsSeventeen studies involving 399 patients and 401 lesions met the inclusion criteria. Nearly 99%(95%CI=0.98-1.00) of lesions achieved good technical success rate.Notably, 83.88% of the patients received RFA under general anesthesia (333/397) whereas 15.87% received RFA under local anesthesia (63/397). Of the 63, 98.41% tolerated the pain associated with the procedure. Majority of patients (65.74%, 261/397) underwent surgical excision of the tumor after ablation whereas in a few patients (34.26%, 136/397), the tumor tissue was retained in the breast after ablation. Complete ablation was achieved in 96% of patients for a mean time of 15.8 minutes (95%CI=0.93-0.99). Overall, only 2% (95%CI=0.01-0.04) of the individuals developed complications. Skin burns (2.02%, 8/397) were the most common complications. There was no local recurrence after a median follow-up of 27.29 months, whether or not they underwent surgical resection following RFA.ConclusionThe results show that RFA for breast cancer smaller than 2 cm is safe and effective. However, prospective studies are needed to validate this conclusion.

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The efficacy and safety of Tyrosine kinase inhibitors in HER-2 positive breast cancer with brain metastases: a systematic review and meta analysis

The Breast ◽

10.1016/s0960-9776(21)00145-4 ◽

2021 ◽

Vol 56 ◽

pp. S41

Author(s):

Y. Yu ◽

J. Zhang ◽

K. Huang ◽

Y. Lin ◽

C. Song

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Brain Metastases ◽

Tyrosine Kinase ◽

Tyrosine Kinase Inhibitors ◽

Kinase Inhibitors ◽

Meta Analysis ◽

Efficacy And Safety ◽

Her 2 ◽

Positive Breast Cancer

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Modified percutaneous radiologic gastrostomy technique without endoscopic or nasogastric access

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0086-8 ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Reda Tabashy ◽

Amira Darwish ◽

Ashraf Ibrahim ◽

Mohamed Gad El-Mola

Keyword(s):

Esophageal Cancer ◽

Success Rate ◽

Nasogastric Tube ◽

Conventional Technique ◽

Fluoroscopic Guidance ◽

Efficacy And Safety ◽

Technical Success ◽

Technical Success Rate ◽

Major Complications ◽

Percutaneous Radiologic Gastrostomy

Abstract Background The aim of this study is to evaluate the efficacy and safety of a modified percutaneous radiologic gastrostomy (MPRG) technique under ultrasound and fluoroscopic guidance without endoscopic or nasogastric access. Results The study included 24 patients: 10 males and 14 females whose ages ranged from 44 to 80 years old. Ten patients had esophageal cancer and 14 patients had neck cancer. Technical success was achieved in 23 out of the 25 procedures (92%). Two procedures failed (8%) and were converted to the conventional technique by using the nasogastric tube. No major complications were reported. Minor complications were observed in 5 patients (20%): intraperitoneal air and contrast leakage in 4 patients and focal mucosal dissection by the contrast in 1 patient. Conclusion The MPRG has high technical success rate, is safe with no major complications, and is most feasible when endoscopic or nasogastric access cannot be performed.

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Efficacy and safety of radiofrequency ablation for treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials

Journal of International Medical Research ◽

10.1177/03000605211006647 ◽

2021 ◽

Vol 49 (4) ◽

pp. 030006052110066

Author(s):

Hua Zhang ◽

Bo Wang ◽

Jie He ◽

Zhongju Du

Keyword(s):

Radiofrequency Ablation ◽

Knee Osteoarthritis ◽

Randomized Controlled Trials ◽

Data Extraction ◽

Meta Analysis ◽

Cochrane Review ◽

Controlled Trials ◽

Efficacy And Safety ◽

Serious Adverse Events ◽

Randomized Controlled

Objective To evaluate the efficacy and safety of radiofrequency ablation for the treatment of knee osteoarthritis. Methods A literature review was conducted using the PubMed, Cochrane Review, Embase, and Google Scholar databases. Two reviewers independently assessed the eligibility of all retrieved studies. The research was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure the reliability and verity of the results. The statistical analysis was performed using STATA version 13.0. Results Nine randomized controlled trials were collected for the data extraction and meta-analysis. Significant differences in the pain score at 4, 12, and 24 weeks were found between patients treated with radiofrequency ablation and those treated with placebo. Furthermore, the use of radiofrequency ablation was associated with an improved outcome of the Western Ontario and McMaster Universities Arthritis Index at 4, 12, and 24 weeks. No serious adverse events were observed in any patients who underwent radiofrequency ablation. Conclusion Radiofrequency ablation is efficacious and safe for reducing pain and improving knee function in patients with knee osteoarthritis, without increasing the risk of adverse effects.

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Efficacy and safety of PARP inhibitors in patients with BRCA-mutated advanced breast cancer: A meta-analysis and systematic review

The Breast ◽

10.1016/j.breast.2021.08.009 ◽

2021 ◽

Author(s):

Ximu Sun ◽

Xin Wang ◽

Jie Zhang ◽

Zhixia Zhao ◽

Xin Feng ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Advanced Breast Cancer ◽

Meta Analysis ◽

Parp Inhibitors ◽

Advanced Breast ◽

Efficacy And Safety

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Treatment of early-stage breast cancer with percutaneous thermal ablation, an open-label randomised phase 2 screening trial: rationale and design of the THERMAC trial

BMJ Open ◽

10.1136/bmjopen-2021-052992 ◽

2021 ◽

Vol 11 (9) ◽

pp. e052992

Author(s):

Elles M F van de Voort ◽

Gerson M Struik ◽

Linetta B Koppert ◽

Adriaan Moelker ◽

Reno Debets ◽

...

Keyword(s):

Breast Cancer ◽

Thermal Ablation ◽

Surgical Excision ◽

Maximum Diameter ◽

Phase 2 ◽

Open Label ◽

Phase 3 ◽

Complete Ablation ◽

Study Results ◽

Screening Trial

IntroductionBreast cancer is the most frequently diagnosed malignancy worldwide but almost half of the patients have an excellent prognosis with a 5-year survival rate of 98%–99%. These patients could potentially be treated with thermal ablation to avoid surgical excision, reduce treatment-related morbidity and increase patients’ quality of life without jeopardising treatment effectiveness. Previous studies showed highest complete ablation rates for radiofrequency, microwave and cryoablation. However, due to heterogeneity among studies, it is unknown which of these three techniques should be selected for a phase 3 comparative study.Methods and analysisThe aim of this phase 2 screening trial is to determine the efficacy rate of radiofrequency, microwave and cryoablation with the intention to select one treatment for further testing in a phase 3 trial. Additionally, exploratory data are obtained for the phase 3 trial. The design is a multicentre open-label randomised phase 2 screening trial. Patients with unifocal, invasive breast cancer with a maximum diameter of 2 cm without lymph node or distant metastases are included. Triple negative, Bloom-Richardson grade 3 tumours and patients with an indication for neoadjuvant chemotherapy will be excluded. Included patients will be allocated to receive one of the three thermal ablation techniques. Three months later surgical excision will be performed to determine the efficacy of thermal ablation. Treatment efficacy in terms of complete ablation rate will be assessed with CK 8/18 and H&E staining. Secondary outcomes include feasibility of the techniques in an outpatient setting, accuracy of MRI for complete ablation, patient satisfaction, adverse events, side effects, cosmetic outcome, system usability and immune response.Ethics and disseminationThis study protocol was approved by Medical Research Ethics Committee of the Erasmus Medical Center, Rotterdam, the Netherlands. Study results will be submitted for publication in peer-reviewed journals.Trial registration numberNL9205 (www.trialregister.nl); Pre-results.

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Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis

European Radiology ◽

10.1007/s00330-016-4668-9 ◽

2017 ◽

Vol 27 (8) ◽

pp. 3199-3210 ◽

Cited By ~ 33

Author(s):

Giovanni Mauri ◽

Luca Maria Sconfienza ◽

Lorenzo Carlo Pescatori ◽

Maria Paola Fedeli ◽

Marco Alì ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Minimally Invasive ◽

Meta Analysis ◽

Percutaneous Ablation ◽

Technical Success

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Efficacy and Safety of Everolimus in the Treatment of Metastatic Breast Cancer: A Systematic Review and Meta-Analysis

Value in Health ◽

10.1016/j.jval.2018.04.088 ◽

2018 ◽

Vol 21 ◽

pp. S15

Author(s):

RK Hyderboini ◽

R Thode ◽

M Malode ◽

V Pinigani ◽

J Nathani ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Metastatic Breast Cancer ◽

Meta Analysis ◽

Metastatic Breast ◽

Efficacy And Safety

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Abstract 16680: Endovascular Therapy of Svc Syndrome-a Systematic Review

Circulation ◽

10.1161/circ.142.suppl_3.16680 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Abdul Hussain Azizi ◽

Irfan Shafi ◽

Matthew Zhao ◽

Vladimir Lakhter ◽

Riyaz Bashir

Keyword(s):

Systematic Review ◽

Success Rate ◽

Recurrence Rate ◽

Endovascular Therapy ◽

Meta Analysis ◽

Restenosis Rate ◽

Technical Success ◽

Recurrence Rates ◽

Technical Success Rate ◽

Svc Syndrome

Background: Superior vena cava (SVC) syndrome is caused by the occlusion of the SVC and can result in significant morbidity and mortality. Recently, endovascular therapy (ET) has become the standard of care for majority of these patients. We performed a systematic review of available literature to assess the contemporary technical success rate, restenosis rate, and recurrence rate of SVC syndrome following endovascular intervention. Methods: We searched PubMed, Cochrane Library, and Embase databases from 1988 to 2019 for studies on Endovascular Therapy for SVC syndrome. After screening 709 records, 13 studies were included. Screening was conducted using Rayyan QCRI software for systemic reviews. Studies included full-length journal articles on SVC syndrome and ET among adults (18+ years). Case reports, or case series with <20 patients were excluded. Data analysis was performed using OpenMeta software. Proportions and 95% confidence intervals (CIs) were calculated using random effects models. Heterogeneity among studies was assessed using Q and I 2 statistics. We evaluated the end-points of the technical success, restenosis rate and recurrence rates in SVC syndrome patients after endovascular stenting Results: A meta-analysis of 13 studies included a total of 1024 patients. The results of our meta-analysis show a weighted technical success rate of 98.6% (95% CI 0.97 – 0.99) (Fig. 1A), restenosis rate of 11.8% (95 CI 0.08-0.14) (Fig 1B) and recurrence rate of 9.9% (95% CI 0.06-0.13) (Fig 1C). Our studies had a substantial heterogeneity (I 2 ) of 52-80%. Figures:Figure 1A Figure 1B Figure 1C Conclusions: Our systematic review revealed high technical success rate, low restenosis, and recurrence rates after endovascular therapy supporting the paradigm of endovascular therapy as first line treatment for patients with SVC syndrome. Disclosures: Dr. Bashir has equity interest in Thrombolex Inc.

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