Department of Surgery, TweeSteden Hospital, Tilburg, The Netherlands.
Eur J Surg Oncol. 2012 Oct;38(10):910-7. doi: 10.1016/j.ejso.2012.04.015. Epub 2012 Jun 7.
Patients with breast cancer metastasized to the liver have a median survival of 4-33 months and treatment options are usually restricted to palliative systemic therapy. The aim of this observational study was to evaluate the effectiveness and safety of resection of liver metastases from breast cancer and to identify prognostic factors for overall survival.
Patients were identified using the national registry of histo- and cytopathology in the Netherlands (PALGA). Included were all patients who underwent resection of liver metastases from breast cancer in 11 hospitals in The Netherlands of the last 20 years. Study data were retrospectively collected from patient files.
A total of 32 female patients were identified. Intraoperative and postoperative complications occurred in 3 and 11 patients, respectively. There was no postoperative mortality. After a median follow up period of 26 months (range, 0-188), 5-year and median overall survival after partial liver resection was 37% and 55 months, respectively. The 5-year disease-free survival was 19% with a median time to recurrence of 11 months. Solitary metastases were the only independent significant prognostic factor at multivariate analysis.
Resection of liver metastases from breast cancer is safe and might provide a survival benefit in a selected group of patients. Especially in patients with solitary liver metastasis, the option of surgery in the multimodality management of patients with disseminated breast cancer should be considered.
患有转移性乳腺癌的患者的中位生存期为 4-33 个月,治疗选择通常仅限于姑息性全身治疗。本观察性研究的目的是评估乳腺癌肝转移切除术的有效性和安全性,并确定总生存期的预后因素。
使用荷兰组织学和细胞学病理登记处(PALGA)确定患者。包括过去 20 年在荷兰 11 家医院接受乳腺癌肝转移切除术的所有患者。研究数据从患者档案中回顾性收集。
共确定了 32 名女性患者。分别有 3 名和 11 名患者发生术中及术后并发症。无术后死亡。中位随访 26 个月(范围 0-188)后,部分肝切除术后 5 年和中位总生存率分别为 37%和 55 个月。5 年无病生存率为 19%,复发时间中位数为 11 个月。单发转移是多变量分析中唯一独立的显著预后因素。
乳腺癌肝转移切除术是安全的,并可能为选定的患者群体提供生存获益。特别是对于单发肝转移患者,在对播散性乳腺癌患者的多模式治疗中,应考虑手术的选择。