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肝切除在乳腺癌肝转移病例中的重要性。

Importance of liver resection in case of hepatic breast cancer metastases.

作者信息

Ehrl Denis, Rothaug Katharina, Hempel Dirk, Rau Horst-Günter

出版信息

Hepatogastroenterology. 2013 Nov-Dec;60(128):2026-33.

Abstract

BACKGROUND/AIMS: Primary focus of the therapy of metastatic breast cancer is currently a systemic therapy. Surgical therapies are of minor importance. Aim of this study was to investigate the relevance of hepatectomy in case of hepatic breast cancer metastases (HBCM) as an important part of multimodal therapy.

METHODOLOGY

From January 2002 to December 2011, 30 patients with HBCM underwent hepatectomy. Criteria for hepatectomy were good condition, technical feasibility and control of extrahepatic metastases. For a heterogeneous group of women with HBCM the 3- and 5-year survival rate was determined by Kalpan-Meier survival estimate.

RESULTS

The postoperative morbidity was 13.3%, the mortality rate was 3.3%. Minor hepatectomy has been performed in 62.1% and major hepatectomy in 37.9% of the cases. In all patients a R0 resection margin was performed. At a median follow-up interval of 34.1 months, 16 patients were still alive. The 3- and 5-year survival rates after surgically resection of HBCM in our collective were 31.0% and 20.7%.

CONCLUSIONS

Hepatectomy is a safe therapy with low morbidity, mortality and improves long-term survival in most patients with limited, resectable HBCM. In our opinion patient selection should not be that strict. The combination of systemic and surgical therapies can improve prognosis and long-term survival of these patients.

摘要

背景/目的:目前转移性乳腺癌治疗的主要重点是全身治疗。手术治疗的重要性较低。本研究的目的是探讨肝切除术在肝转移性乳腺癌(HBCM)作为多模式治疗重要组成部分时的相关性。

方法

2002年1月至2011年12月,30例HBCM患者接受了肝切除术。肝切除术的标准是身体状况良好、技术可行性以及肝外转移得到控制。对于一组异质性的HBCM女性患者,通过Kaplan-Meier生存估计确定3年和5年生存率。

结果

术后发病率为13.3%,死亡率为3.3%。62.1%的病例进行了小范围肝切除术,37.9%的病例进行了大范围肝切除术。所有患者均实现了R0切缘。在中位随访间隔34.1个月时,16例患者仍存活。我们研究组中HBCM手术切除后的3年和5年生存率分别为31.0%和20.7%。

结论

肝切除术是一种安全的治疗方法,发病率和死亡率低,可提高大多数局限性、可切除HBCM患者的长期生存率。我们认为患者选择不应过于严格。全身治疗和手术治疗相结合可改善这些患者的预后和长期生存率。

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