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香港中文女性乳腺癌肝转移行肝切除术的生存分析:倾向评分分析。

Survival analysis of breast cancer liver metastasis treated by hepatectomy: A propensity score analysis for Chinese women in Hong Kong.

机构信息

Department of Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.

Department of Surgery, Queen Mary Hospital, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2019 Oct;18(5):452-457. doi: 10.1016/j.hbpd.2019.08.001. Epub 2019 Aug 22.

Abstract

BACKGROUND

Survival of patients with breast cancer liver metastasis is very poor. This study aimed to analyze the survival outcome of hepatectomy for this patient population.

METHODS

From January 1995 to December 2014, 2522 patients with liver cancer received hepatectomy at our hospital. Twenty-one of them, all female, received the operation for breast cancer liver metastasis. Performance was compared with patients with colorectal liver metastasis treated with hepatectomy after propensity score analysis in a ratio of 1:3.

RESULTS

Twenty-one patients received hepatectomy for breast cancer. After propensity score matching, 63 patients who had hepatectomy for colorectal cancer were selected for comparison. There was no significant difference in immediate or short-term outcomes between the two groups of patients in terms of operative time, blood loss and surgical morbidities. All patients with breast cancer had R0 resection. No hospital death occurred. After hepatectomy, the 1-, 3- and 5-year overall survival rates were 100.0%, 58.9% and 58.9% respectively in patients with breast cancer. The 1-, 3- and 5-year overall survival rates were 95.0%, 57.2% and 39.7% respectively in patients with colorectal cancer (P = 0.572). On multivariate analysis, triple negative status was the only independent poor prognostic factor in breast cancer liver metastasis (OR = 6.411; 95% CI: 1.351-30.435; P = 0.019).

CONCLUSIONS

Hepatectomy is a safe and effective way of treating breast cancer liver metastasis at experienced centers where multidisciplinary adjuvant treatments are available. It can be considered more frequently as part of the multidisciplinary care for this patient population.

摘要

背景

乳腺癌肝转移患者的生存预后非常差。本研究旨在分析肝切除术治疗这部分患者的生存结局。

方法

1995 年 1 月至 2014 年 12 月,我院共有 2522 例肝癌患者接受了肝切除术,其中 21 例为乳腺癌肝转移患者,采用倾向评分匹配方法,按 1:3 的比例与同期接受肝切除术治疗的结直肠癌肝转移患者进行比较。

结果

21 例乳腺癌患者接受了肝切除术。经倾向评分匹配后,选择了 63 例接受结直肠癌肝切除术的患者进行比较。两组患者在手术时间、术中出血量和手术并发症方面无显著差异。所有乳腺癌患者均达到 R0 切除,无院内死亡。肝切除术后,乳腺癌患者的 1、3、5 年总生存率分别为 100.0%、58.9%和 58.9%,结直肠癌患者的 1、3、5 年总生存率分别为 95.0%、57.2%和 39.7%(P=0.572)。多因素分析显示,三阴性状态是乳腺癌肝转移的唯一独立预后不良因素(OR=6.411;95%CI:1.351-30.435;P=0.019)。

结论

在多学科辅助治疗手段完备的经验丰富的中心,肝切除术治疗乳腺癌肝转移是一种安全有效的方法。对于这部分患者,可更多地考虑将其作为多学科治疗的一部分。

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