Thelen Armin, Benckert Christoph, Jonas Sven, Lopez-Hänninen Enrique, Sehouli Jalid, Neumann Ulf, Rudolph Birgit, Neuhaus Peter
Department of General, Visceral and Transplantation Surgery, Campus Virchow-Klinikum, Charité Universitaetsmedizin Berlin, Berlin, Germany.
J Surg Oncol. 2008 Jan 1;97(1):25-9. doi: 10.1002/jso.20911.
The value of liver resection for metastases from breast cancer is still controversial. This study was conducted to clarify safety and effectiveness of hepatectomy in this conditions and to identify selection criteria for patients suitable for liver resection.
From January 1988 to December 2006, 39 patients underwent liver resection for metastases from breast cancer. The outcome of these 39 patients was retrospectively reviewed using a prospective database. Prognostic factors for patient survival were determined by univariate and multivariate analysis.
None of the patients died perioperatively and the morbidity rate was 13% (n = 5). The overall 1-, 3-, and 5-year survival rates were 77%, 50%, and 42%, respectively. In the univariate analysis, metastatic manifestation prior to hepatectomy, vascular invasion and resection margin revealed statistically significant influence on survival. The multivariate analysis identified only resection margin as an independent prognostic factor for survival.
Liver resection should be considered in the multimodal treatment approach of patients with metastatic breast cancer. Hepatic resection can be performed with low risk and offers a chance of long-term survival. Achievement of a curative resection and less important absence of previous metastatic manifestation represent suitable criteria to select patients for liver resection.
乳腺癌肝转移行肝切除的价值仍存在争议。本研究旨在阐明在此种情况下肝切除的安全性和有效性,并确定适合肝切除患者的选择标准。
1988年1月至2006年12月,39例患者因乳腺癌肝转移接受肝切除。利用前瞻性数据库对这39例患者的结果进行回顾性分析。通过单因素和多因素分析确定患者生存的预后因素。
无患者围手术期死亡,发病率为13%(n = 5)。1年、3年和5年总生存率分别为77%、50%和42%。单因素分析中,肝切除术前转移表现、血管侵犯和切缘对生存有统计学显著影响。多因素分析仅确定切缘是生存的独立预后因素。
在转移性乳腺癌患者多模式治疗中应考虑肝切除。肝切除可在低风险下进行,并提供长期生存机会。实现根治性切除以及既往无转移表现是选择肝切除患者的合适标准。