乳腺肝转移——发病率、诊断及预后
Breast liver metastases--incidence, diagnosis and outcome.
作者信息
Hoe A L, Royle G T, Taylor I
机构信息
University Surgical Unit, Royal South Hants Hospital, Southampton.
出版信息
J R Soc Med. 1991 Dec;84(12):714-6. doi: 10.1177/014107689108401207.
Breast liver metastases are uncommon and have not been well reported. We studied the clinical outcome of 47 patients who developed liver metastases out of 912 breast cancer patients treated between 1982 and 1987, an incidence of 5.2%. The median disease free interval prior to clinical liver metastases was 20.2 months (range 4-192 months). The most frequent clinical presentations were hepatomegaly (70%) and abdominal pain (34%). The diagnosis was confirmed on ultrasound scan in 72.7% patients. Thirty-one patients (70.5%) received specific treatment with both hormone and chemotherapy but only six showed any evidence of objective response, the majority of whom had metastases only in the liver. The median survival of treated patients was 4 months and absence of jaundice, response to treatment and liver metastases only were associated with significantly better survival. In conclusion breast liver metastases usually present as a manifestation of disseminated disease and have an appalling prognosis. When they occur as an initial site the prognosis is better but very few patients overall respond to conventional treatment.
乳腺肝转移并不常见，相关报道也不多。我们研究了1982年至1987年间接受治疗的912例乳腺癌患者中发生肝转移的47例患者的临床结局，发生率为5.2%。临床肝转移前的无病间期中位数为20.2个月（范围4 - 192个月）。最常见的临床表现是肝肿大（70%）和腹痛（34%）。72.7%的患者经超声检查确诊。31例患者（70.5%）接受了激素和化疗的特异性治疗，但只有6例显示出客观缓解的迹象，其中大多数仅在肝脏有转移。接受治疗患者的中位生存期为4个月，无黄疸、对治疗有反应且仅发生肝转移与显著更好的生存期相关。总之，乳腺肝转移通常表现为播散性疾病的一种表现，预后极差。当它们作为初始部位出现时预后较好，但总体上很少有患者对传统治疗有反应。
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