Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
Eur J Surg Oncol. 2011 Jul;37(7):549-57. doi: 10.1016/j.ejso.2011.04.013. Epub 2011 May 24.
To analyze surgical treatment of breast cancer liver metastases (BCLM) regarding selection criteria, outcome and prognostic parameters.
We searched Embase and Medline for all studies published 1999-2010.
Resection was associated with a median survival (MOS) of 20-67 months and 5-year survival of 21-61%. Local ablation also had a favorable outcome; MOS was 30-60 months and 5-year survival 27-41%. Regarding selection, no specific limits regarding the number and size of BCLM can be given. Features of the primary breast cancer (BC) were not significant for the prognosis. Microscopically radical (R0) resection is a positive prognostic factor, while the effects of disease interval, hormone receptor status and response to preoperative chemotherapy were divergent. The presence of EHD had a negative effect on survival in some studies, but failed to have so in other studies.
Surgical therapy may benefit a subset of patients with BCLM. Resection may be indicated, if an RO-resection can be done with a low risk of mortality. Liver resection in the presence of extrahepatic disease remains controversial, while patients with BCLM and bone metastases could possibly be managed differently than other EHD.
分析乳腺癌肝转移（BCLM）的外科治疗选择标准、结果和预后参数。
我们在 Embase 和 Medline 上检索了 1999 年至 2010 年发表的所有研究。
切除术与中位生存时间（MOS）20-67 个月和 5 年生存率 21-61%相关。局部消融也有较好的结果；MOS 为 30-60 个月，5 年生存率为 27-41%。关于选择，不能针对 BCLM 的数量和大小给出具体的限制。原发性乳腺癌（BC）的特征对预后没有显著影响。显微镜下根治性（R0）切除是一个积极的预后因素，而疾病间隔、激素受体状态和术前化疗反应的影响则存在分歧。在一些研究中，EHD 的存在对生存有负面影响，但在其他研究中则没有。
外科治疗可能对一部分 BCLM 患者有益。如果可以进行低死亡率的 RO 切除，则可以考虑进行切除术。肝外疾病存在时的肝切除术仍存在争议，而有 BCLM 和骨转移的患者可能需要与其他 EHD 患者进行不同的治疗。
