Prognostic factors for patients with hepatic metastases from breast cancer.
Median survival from liver metastases secondary to breast cancer is only a few months, with very rare 5-year survival. This study reviewed 145 patients with liver metastases from breast cancer to determine factors that may influence survival. Data were analysed using Kaplan-Meier survival curves, univariate and multivariate analysis. Median survival was 4.23 months (range 0.16-51), with a 27.6% 1-year survival. Factors that significantly predicted a poor prognosis on univariate analysis included symptomatic liver disease, deranged liver function tests, the presence of ascites, histological grade 3 disease at primary presentation, advanced age, oestrogen receptor (ER) negative tumours, carcinoembryonic antigen of over 1000 ng ml(-1) and multiple vs single liver metastases. Response to treatment was also a significant predictor of survival with patients responding to chemo- or endocrine therapy surviving for a median of 13 and 13.9 months, respectively. Multivariate analysis of pretreatment variables identified a low albumin, advanced age and ER negativity as independent predictors of poor survival. The time interval between primary and metastatic disease, metastases at extrahepatic sites, histological subtype and nodal stage at primary presentation did not predict prognosis. Awareness of the prognostic implications of the above factors may assist in selecting the most appropriate treatment for these patients.British Journal of Cancer (2003) 89, 284-290. doi:10.1038/sj.bjc.6601038 www.bjcancer.com
Wyld
L
L
Department of Surgical and Anaesthetic Sciences, University of Sheffield, Sheffield S10 2JF, UK. l.wyld@sheffield.ac.uk
Gutteridge
E
E
Pinder
S E
SE
James
J J
JJ
Chan
S Y
SY
Cheung
K L
KL
Robertson
J F R
JF
Evans
A J
AJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000418:Albumins / Q000032:analysis; D001943:Breast Neoplasms / Q000473:pathology*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005260:Female; D006801:Humans; D008099:Liver / Q000502:physiology; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
D000418:Albumins; D002272:Carcinoembryonic Antigen