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乳腺癌肝转移的手术治疗-影响疗效的因素。

Surgery for breast cancer liver metastases - factors determining results.

机构信息

Professor of Surgery, Department of Surgery, University Hospital, Faculty of Medicine, Alej Svobody 80, 304 60 Pilsen, Czech Republic.

出版信息

Anticancer Res. 2014 Mar;34(3):1281-6.

Abstract

BACKGROUND/AIM: The results of the surgical treatment of liver metastases from breast cancer (BCLMs) may be determined by various factors. The aim of the present study was to specify the risk factors for surgical treatment of BCLM.

PATIENTS AND METHODS

Twenty-four female patients with BCLMs were treated with liver resection or radiofrequency ablation (RFA). We evaluated the effects of patient age, time interval between the breast cancer and BCLM surgery, the type of surgical procedure, histopathological findings of the primary tumor, the number and overall diameter of BCLMs, the presence of resectable extra-hepatic metastases, and local tumor recurrence after breast cancer surgery on patients' overall (OS) and progression-free survival (PFS).

RESULTS

Age <50 years and shorter interval between breast and liver surgery were risk factors for poorer OS (p<0.02 and p<0.01, respectively) and for PFS (p<0.01 and p<0.01, respectively). The presence of extra-hepatic metastases was a risk factor for OS (p<0.005). An overall diameter of BCLM ≥3.5 cm and a negative status of both estrogen (ER) and progesterone receptors (PR) in the primary tumor were risk factors for poorer PFS (p<0.009 and p<0.0003, respectively).

CONCLUSION

The risk factors for surgery for BCLMs are age <50 years, the presence of extra-hepatic metastases, hormone receptor negativity of the primary tumor and an overall BCLM diameter ≥3.5 cm.

摘要

背景/目的:乳腺癌肝转移(BCLM)的手术治疗结果可能由多种因素决定。本研究旨在明确影响 BCLM 手术治疗的危险因素。

患者与方法

对 24 例接受肝切除术或射频消融术(RFA)治疗的 BCLM 女性患者进行评估。我们评估了患者年龄、乳腺癌与 BCLM 手术之间的时间间隔、手术类型、原发肿瘤的组织病理学发现、BCLM 的数量和总直径、可切除的肝外转移灶的存在以及乳腺癌手术后局部肿瘤复发对患者总生存(OS)和无进展生存(PFS)的影响。

结果

年龄<50 岁和乳腺癌与肝手术之间的时间间隔较短是 OS(p<0.02 和 p<0.01)和 PFS(p<0.01 和 p<0.01)较差的危险因素。肝外转移的存在是 OS(p<0.005)的危险因素。BCLM 的总直径≥3.5 cm 和原发肿瘤中雌激素(ER)和孕激素受体(PR)均阴性是 PFS 较差的危险因素(p<0.009 和 p<0.0003)。

结论

BCLM 手术的危险因素是年龄<50 岁、存在肝外转移、原发肿瘤激素受体阴性和 BCLM 总直径≥3.5 cm。

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