Systematic review of early and long-term outcome of liver resection for metastatic breast cancer: Is there a survival benefit?

BACKGROUND

Isolated liver metastases occur rarely in patients with metastatic breast cancer. The success of liver resection (LR) for other metastatic disease has led centres to explore the option of LR for patients with isolated breast cancer liver metastases (BCLM). A number of small series have been published in the literature, however the evidence is conflicting. This study aimed to systematically review the literature to determine the perioperative outcome and survival of patients undergoing LR for BCLM.

METHODS

An electronic search of Medline and Embase databases was performed to identify all published series. Patient demographics, management, peri-operative outcome and overall survival (OS) were obtained.

RESULTS

A total of 1705 articles were identified of which 531 included patients with non-colorectal and non-neuroendocrine metastases. 43 articles including 1686 patients, met all the inclusion and exclusion criteria. R0 resection was achieved in 83% (683/825). Morbidity and 30-day mortality rates were 20% (174/852) and 0.7% (6/918), respectively. The median OS was 36 months (12-58 months). The median 1-, 3-and 5-year OS were 90%, 56% and 37%, respectively.

CONCLUSIONS

LR for BCLM can be carried out with acceptable peri-operative risks in selected patients with survival outcomes that appear to be superior to chemotherapy alone.