Zegarac M, Nikolic S, Gavrilovic D, Jevric M, Kolarevic D, Nikolic-Tomasevic Z, Kocic M, Djurisic I, Inic Z, Ilic V, Santrac N
Clinic of Surgical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
J BUON. 2013 Oct-Dec;18(4):859-65.
Isolated liver metastases (LMs) from breast cancer (BC) occur in only 1-3% of the cases. Resection of isolated LMs improves survival. We examined the prognostic factors for time to LM development, disease free survival (DFS) and overall survival (OS) after BCLM resection.
From 2006 to 2009, 32 patients underwent LM resection. All of them had breast cancer surgery for their primary tumor and developed resectable LMs as the first and only site of disease progression.
LMs developed after a median of 25 months. With a median follow up of 37 months (range 7-66) after metastases resection, median DFS and OS (with 95% CI) were 22.5 (12-40) and 37 (≥23) months, respectively. Tumor size ≥3 vs <3 cm and adjuvant chemotherapy vs no adjuvant chemotherapy correlated with shorter time to LM development (p<0.01 for both parameters). These parameters and BC negative estrogen (ER)/ progesterone receptors (PR) (ER?/PR? vs other) were related with shorter DFS. Positive (vs negative) axillary lymph nodes and BC negative ER/ PR (ER?/PR? vs other) status correlated with shorter OS (p<0.01 for both parameters). A period to metastases development ≥ 24 months (vs ≤24) and single (vs multiple) metastases were related with longer DFS and OS (p<0.01 for both conditions).
Despite the relatively small number of patients in this study, we believe that positive ER/PR status for both BC and LMs, negative axillary lymph nodes, time to liver metastases development >24 months and single liver metastases predict longer DFS and OS after LM resection.
乳腺癌（BC）孤立性肝转移（LMs）仅在1%-3%的病例中出现。孤立性肝转移瘤切除术可提高生存率。我们研究了BCLM切除术后肝转移发生时间、无病生存期（DFS）和总生存期（OS）的预后因素。
2006年至2009年，32例患者接受了肝转移瘤切除术。他们均因原发性肿瘤接受了乳腺癌手术，且出现可切除的肝转移瘤作为疾病进展的首个也是唯一部位。
肝转移发生的中位时间为25个月。转移瘤切除术后中位随访37个月（范围7-66个月），中位DFS和OS（95%CI）分别为22.5（12-40）个月和37（≥23）个月。肿瘤大小≥3cm与<3cm以及辅助化疗与未进行辅助化疗与肝转移发生时间较短相关（两个参数p均<0.01）。这些参数以及BC雌激素受体（ER）/孕激素受体（PR）阴性（ER?/PR?与其他情况相比）与较短的DFS相关。腋窝淋巴结阳性（与阴性相比）以及BC ER/PR阴性（ER?/PR?与其他情况相比）状态与较短的OS相关（两个参数p均<0.01）。转移瘤发生时间≥24个月（与≤24个月相比）以及单个（与多个）转移瘤与较长的DFS和OS相关（两种情况p均<0.01）。
尽管本研究中的患者数量相对较少，但我们认为BC和LMs的ER/PR状态为阳性、腋窝淋巴结阴性、肝转移发生时间>24个月以及单个肝转移可预测LM切除术后更长的DFS和OS。
