Xigan He, Qiongyan Zhang, and Yun Feng contributed equally to this work.
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Surgery is becoming more practical and effective than conservative treatment in improving the poor outcomes of patients with breast cancer liver metastasis (BCLM). However, there is no generally acknowledged set of standards for identifying BCLM candidates who will benefit from surgery.
Between January 2011 and September 2018, 67 female BCLM patients who underwent partial hepatectomy were selected for analysis in the present study. Prognostic factors after hepatectomy were determined. Univariate and multivariate analyses were performed to identify predictors of overall survival (OS) and intrahepatic recurrence-free survival (IHRFS).
The 1-, 3- and 5-year OS of patients treated with surgery was 93.5%, 73.7% and 32.2%, respectively, with a median survival time of 57.59 months. The Pringle manoeuvre [hazard radio (HR) = 0.117, 95% CI0.015–0.942, p = 0.044] and an increased interval between breast surgery and BCLM diagnosis (HR0.178, 95% CI 0.037–0.869, p = 0.033) independently predicted improved overall survival for BCLM patients. The 1-, 2- and 3-year IHRFS of patients who underwent surgery was 62.8, 32.6% and 10.9%, respectively, with a median intrahepatic recurrence-free survival time of 13.47 months. Moderately differentiated tumours (HR 0.259, 95% CI 0.078–0.857, p = 0.027) and the development of liver metastasis more than 2 years after breast surgery (HR 0.270, 95% CI 0.108–0.675, p = 0.005) might be predictors of increased IHRFS.
An interval of more than 2 years between breast cancer surgery and liver metastasis seems to be an indication of liver surgery in BCLM patients. The Pringle manoeuvre and moderately differentiated tumours are potential predictors associated with OS and IHRFS, respectively, as benefits from liver resection. Studies with increased sample sizes are warranted to validate our results.
DeSantis C, Ma J, Bryan L. Jemal A (2014) Breast cancer statistics. CA A Cancer J Clin. 2013;64(1):52–62. https://doi.org/10.3322/caac.21203.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA A Cancer J Clin. 2018. https://doi.org/10.3322/caac.21492.
Guarneri V, Conte P. Metastatic breast cancer: therapeutic options according to molecular subtypes and prior adjuvant therapy. Oncologist. 2009;14(7):645–56. https://doi.org/10.1634/theoncologist.2009-0078.
Berman AT, Thukral AD, Hwang WT, Solin LJ, Vapiwala N. Incidence and patterns of distant metastases for patients with early-stage breast cancer after breast conservation treatment. Clinical breast cancer. 2013;13(2):88–94. https://doi.org/10.1016/j.clbc.2012.11.001.
Zinser JW, Hortobagyi GN, Buzdar AU, Smith TL, Fraschini G. Clinical course of breast cancer patients with liver metastases. J Clin Oncol. 1987;5(5):773–82.
Adam R, De Gramont A, Figueras J, Guthrie A, Kokudo N, Kunstlinger F, et al. The oncosurgery approach to managing liver metastases from colorectal cancer: a multidisciplinary international consensus. Oncologist. 2012;17(10):1225–399. https://doi.org/10.1634/theoncologist.2012-0121.
Cardoso F, Senkus E, Costa A, Papadopoulos E, Aapro M, Andre F, et al. 4th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)dagger. Ann Oncol. 2018;29(8):1634–57. https://doi.org/10.1093/annonc/mdy192.
National Comprehensive Cancer Network. (NCCN) Clinical Practice Guidelines in Oncology. Breast Cancer, Version 1. 2019. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf Accessed 14 March 2019.
Adam R, Aloia T, Krissat J, Bralet MP, Paule B, Giacchetti S, et al. Is liver resection justified for patients with hepatic metastases from breast cancer? Ann Surg. 2006;244(6):897–907. https://doi.org/10.1097/01.sla.0000246847.02058.1b (discussion -8).
Caralt M, Bilbao I, Cortes J, Escartin A, Lazaro JL, Dopazo C, et al. Hepatic resection for liver metastases as part of the "oncosurgical" treatment of metastatic breast cancer. Ann Surg Oncol. 2008;15(10):2804–10. https://doi.org/10.1245/s10434-008-0072-2.
Hoffmann K, Franz C, Hinz U, Schirmacher P, Herfarth C, Eichbaum M, et al. Liver resection for multimodal treatment of breast cancer metastases: identification of prognostic factors. Ann Surg Oncol. 2010;17(6):1546–54. https://doi.org/10.1245/s10434-010-0931-5.
Cassera MA, Hammill CW, Ujiki MB, Wolf RF, Swanstrom LL, Hansen PD. Surgical management of breast cancer liver metastases. HPB. 2011;13(4):272–8. https://doi.org/10.1111/j.1477-2574.2010.00282.x.
Abbott DE, Brouquet A, Mittendorf EA, Andreou A, Meric-Bernstam F, Valero V, et al. Resection of liver metastases from breast cancer: estrogen receptor status and response to chemotherapy before metastasectomy define outcome. Surgery. 2012;151(5):710–6. https://doi.org/10.1016/j.surg.2011.12.017.
Dittmar Y, Altendorf-Hofmann A, Schule S, Ardelt M, Dirsch O, Runnebaum IB, et al. Liver resection in selected patients with metastatic breast cancer: a single-centre analysis and review of literature. J Cancer Res Clin Oncol. 2013;139(8):1317–25. https://doi.org/10.1007/s00432-013-1440-2.
Ruiz A, Sebagh M, Wicherts DA, Castro-Benitez C, van Hillegersberg R, Paule B, et al. Long-term survival and cure model following liver resection for breast cancer metastases. Breast Cancer Res Treat. 2018;170(1):89–100. https://doi.org/10.1007/s10549-018-4714-1.
Ng KK, Vauthey JN, Pawlik TM, Lauwers GY, Regimbeau JM, Belghiti J, et al. Is hepatic resection for large or multinodular hepatocellular carcinoma justified? Results from a multi-institutional database. Ann Surg Oncol. 2005;12(5):364–73. https://doi.org/10.1245/ASO.2005.06.004.
Vauthey JN, Chaoui A, Do KA, Bilimoria MM, Fenstermacher MJ, Charnsangavej C, et al. Standardized measurement of the future liver remnant prior to extended liver resection: methodology and clinical associations. Surgery. 2000;127(5):512–9. https://doi.org/10.1067/msy.2000.105294.
Pivot X, Asmar L, Hortobagyi GN, Theriault R, Pastorini F, Buzdar A. A retrospective study of first indicators of breast cancer recurrence. Oncology. 2000;58(3):185–90. https://doi.org/10.1159/000012098.
Eichbaum MH, Kaltwasser M, Bruckner T, de Rossi TM, Schneeweiss A, Sohn C. Prognostic factors for patients with liver metastases from breast cancer. Breast Cancer Res Treat. 2006;96(1):53–62. https://doi.org/10.1007/s10549-005-9039-1.
Pocard M, Pouillart P, Asselain B, Salmon R. Hepatic resection in metastatic breast cancer: results and prognostic factors. Eur J Surg Oncol. 2000;26(2):155–9. https://doi.org/10.1053/ejso.1999.0761.
Selzner M, Morse MA, Vredenburgh JJ, Meyers WC, Clavien PA. Liver metastases from breast cancer: long-term survival after curative resection. Surgery. 2000;127(4):383–9.
Treska V, Cerna M, Liska V, Treskova I, Narsanska A, Bruha J. Surgery for breast cancer liver metastases—factors determining results. Anticancer Res. 2014;34(3):1281–6.
Treska V, Cerna M, Kydlicek T, Treskova I. Prognostic factors of breast cancer liver metastasis surgery. Arch Med Sci AMS. 2015;11(3):683–5. https://doi.org/10.5114/aoms.2015.52376.
Kostov DV, Kobakov GL, Yankov DV. Prognostic factors related to surgical outcome of liver metastases of breast cancer. J Breast Cancer. 2013;16(2):184–92. https://doi.org/10.4048/jbc.2013.16.2.184.
Pringle JHV. Notes on the arrest of hepatic hemorrhage due to trauma. Ann Surg. 1908;48(4):541–9.
Makuuchi M, Mori T, Gunven P, Yamazaki S, Hasegawa H. Safety of hemihepatic vascular occlusion during resection of the liver. Surg Gynecol Obstet. 1987;164(2):155–8.
Lin NC, Nitta H, Wakabayashi G. Laparoscopic major hepatectomy: a systematic literature review and comparison of 3 techniques. Ann Surg. 2013;257(2):205–13. https://doi.org/10.1097/SLA.0b013e31827da7fe.
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