Oncology Medicine Department, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
Data Centre, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
ESMO Open. 2020 Jun;5(3):e000695. doi: 10.1136/esmoopen-2020-000695.
Pseudocirrhosis is a radiological term used to describe rapid changes in the contour of liver invaded by metastases and treated with chemotherapy. Our primary objectives were to analyse the clinical and biological characteristics of those patients with breast cancer and to assess the prevalence of complications generally associated with decompensated cirrhosis. We have also assessed associated treatments and response.
This retrospective study included all women with metastatic breast cancer to the liver who had imaging protocols describing diffuse liver contour abnormalities during systemic treatment between 2003 and 2018 in our centre. The following were identified: neoplastic characteristics, complications presented, treatments administered and response.
48 patients were included. There was a trend towards an increased proportion of luminal cancers (88.2%, n=30, p=0052) when compared with our hospital cancer registry. Most patients (97.9%, n=47) had a widespread liver invasion, 58.3% (n=28) had ascites on physical examination; 90% (n=18) of ascites were classified as transudate. Nearly 23% (n=11) of patients had oesophageal varices and 6.5% (n=3) had an episode of variceal rupture. At the time of the appearance of liver contour abnormalities, the most frequently used molecules were: 5-fluorouracil (22.9%; n=11) and cisplatin (18.8%; n=9). A partial response was observed in 52.1% (n=25) of patients.
This is the largest reported series of patients with pseudocirrhosis. Many patients developed complications related to portal hypertension and liver failure, similar to those observed in decompensated cirrhosis. Luminal subtypes could be over-represented. In our series, pseudocirrhosis appears to develop at the expense of extensive liver disease burden and most often under 5-fluorouracil, or its derivatives, with or without cisplatin, possibly following a response to treatment.
假性肝硬化是一个用于描述受转移侵袭的肝脏轮廓在接受化疗后迅速变化的影像学术语。我们的主要目的是分析患有乳腺癌的患者的临床和生物学特征，并评估与代偿性肝硬化相关的常见并发症的发生率。我们还评估了相关的治疗和反应。
本回顾性研究纳入了 2003 年至 2018 年期间在我们中心接受全身治疗期间影像学描述为弥漫性肝脏轮廓异常的转移性乳腺癌女性患者。确定了以下内容：肿瘤特征、出现的并发症、给予的治疗和反应。
共纳入 48 例患者。与我们医院的癌症登记处相比，腔型癌症的比例有增加的趋势（88.2%，n=30，p=0.052）。大多数患者（97.9%，n=47）有广泛的肝脏侵犯，58.3%（n=28）体检时出现腹水；90%（n=18）的腹水为漏出液。近 23%（n=11）的患者有食管静脉曲张，6.5%（n=3）有静脉曲张破裂。在肝脏轮廓异常出现时，最常使用的分子是：5-氟尿嘧啶（22.9%；n=11）和顺铂（18.8%；n=9）。观察到部分缓解的患者有 52.1%（n=25）。
这是报道的最大系列假性肝硬化患者。许多患者出现与门脉高压和肝功能衰竭相关的并发症，与代偿性肝硬化相似。腔型亚型可能过度表达。在我们的系列中，假性肝硬化似乎是在广泛的肝脏疾病负担下发展的，最常发生在 5-氟尿嘧啶或其衍生物下，或与顺铂联合使用，可能是在治疗反应后发生的。
