Phillips Edward, Sethi Mantegh, Vasanthakumar Surammiya, Sherpa Gina, Johnston Stephen, Parton Marina, Kipps Emma, Turner Nicholas C, Foxton Matthew, Okines Alicia
Breast Unit, The Royal Marsden Hospital, London SW3 6JJ, UK.
Department of Surgery, University Hospitals Birmingham, Birmingham B15 2GW, UK.
Cancers (Basel). 2024 Aug 12;16(16):2822. doi: 10.3390/cancers16162822.
Pseudocirrhosis is a diffuse nodularity of the liver that radiologically mimics cirrhosis but is a distinct pathological process. It is seen almost exclusively in patients with liver metastases and may represent a response to systemic treatment. Data on the risk factors for pseudocirrhosis and outcomes are limited. In total, 170 patients with a diagnosis of breast cancer and pseudocirrhosis in a 10-year period were identified and retrospectively analysed. Data were collected on baseline patient characteristics, treatments received, and outcomes. Median time between diagnosis of liver metastases and diagnosis of pseudocirrhosis was 17.1 months (range, 0-149 months). In total, 89.4% of patients received chemotherapy between their diagnosis of breast cancer liver metastases and their diagnosis of pseudocirrhosis, most commonly a taxane (74.7%) or capecitabine (67.1%), and the median treatment lines received was 3. Median OS from first diagnosis of pseudocirrhosis was 7.6 months (95% CI: 6.1-9.6 months) and was longer in patients with HER2+ disease at 16.7 months (95% CI: 6.4-32.9 months), which was statistically significant. In our study, pseudocirrhosis occurred in the presence of liver metastases and was associated with a poor prognosis. HER2+ patients with pseudocirrhosis had a better prognosis than other subtypes, but we did not identify other significant predictors of survival. Chemotherapy was not a prerequisite for pseudocirrhosis development, although the majority of patients had received at least one line of chemotherapy before pseudocirrhosis was diagnosed.
假肝硬化是肝脏的一种弥漫性结节,在放射学上类似于肝硬化,但却是一种独特的病理过程。它几乎仅见于有肝转移的患者,可能代表对全身治疗的一种反应。关于假肝硬化的危险因素和预后的数据有限。在10年期间,共识别并回顾性分析了170例诊断为乳腺癌和假肝硬化的患者。收集了患者的基线特征、接受的治疗和预后的数据。肝转移诊断与假肝硬化诊断之间的中位时间为17.1个月(范围为0 - 149个月)。在乳腺癌肝转移诊断与假肝硬化诊断之间,共有89.4%的患者接受了化疗,最常用的是紫杉烷(74.7%)或卡培他滨(67.1%),接受的中位治疗线数为3。从首次诊断假肝硬化起的中位总生存期为7.6个月(95%可信区间:6.1 - 9.6个月),HER2阳性疾病患者的总生存期更长,为16.7个月(95%可信区间:6.4 - 32.9个月),具有统计学意义。在我们的研究中,假肝硬化发生于肝转移存在的情况下,且与预后不良相关。HER2阳性的假肝硬化患者比其他亚型的预后更好,但我们未发现其他显著的生存预测因素。化疗并非假肝硬化发生的先决条件,尽管大多数患者在假肝硬化诊断前至少接受过一线化疗。