[Analysis of long-term (5-year) survival in patients with metastatic breast cancer to the liver].
Patients with metastatic breast cancer to the liver are generally considered to have a poor prognosis. The purpose of this study was to identify factors contributing to long term survival in 11 patients who were 35 76 years old at the time of diagnosis with liver metastasis, and survived for 5 years. No patients were treated with a standard systemic chemotherapy alone. All of the 11 patients received OK 432 combined adoptive immunotherapy (OK-AIT), 5 underwent hepatectomy as an additional local therapy, and 2 were additionally treated by hepatic arterial infusion chemotherapy. The liver was the primary and secondary sites of metastasis in 8 and 3 of the 11 patients, respectively. In all of the 128 patients given OK-AIT at 5 years after diagnosis, the 5-year survival rates with primary and secondary liver metastases were 11.8. and 5%, respectively. Hormone receptors (HR) were undetermined in 4 patients, positive in 6, and negative in 1 patient, who was also positive for HER2. To determine the relationships among the prognosis of the liver metastasis, AIT indications, HR, and HER2, we analyzed our 139 liver metastasis patients encountered in 2001 and onwards. Fifty-one patients with primary liver metastasis had a median survival time (MST) of 31 months, and a 5-year survival rate of 25%, indicating an improved prognosis. In particular, a MST of 50 months (n=18) in HR (+), HER2 (-) patients was in sharp contrast to the poor prognosis (a MST of 6 months, n=2) in HR (-) HER2 (-) patients. HER2 (+) patients had a MST of 27 months (n=31). Eighty-eight patients with secondary liver metastasis had a MST of only 11 months and a 5-year survival of only 6%; however, the MST in these patients showed the same tendency as in the primary liver metastasis patients: ER (+) HER2 (-) >HER2 (+) >HR (-) HER2 (-) (17, 13, and 4 months, respectively). The response rates of OK-AIT in the primary and secondary liver metastasis patients were 52 and 34%, respectively, showing no significant difference. However, there was a significant difference in the response rate between the HR (+) and HR (-) patients, at 52 and 12%, respectively (p=0.0041). Of the patients in the past, 18 with primary liver metastasis underwent hepatectomy in combination with OK-AIT. Of these 18 patients, 5 had concurrent metastases to other sites, but achieved a 5-year survival rate of 56%, suggesting that it is incorrect to conclude that patients with liver metastasis have generally a poor prognosis. Key
Kan
Norimichi
N
Kan Norimichi Clinic, Shotokukai-Hiei Hospital.
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D016219:Immunotherapy, Adoptive; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D010844:Picibanil / Q000627:therapeutic use; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011987:Receptors, Steroid / Q000032:analysis; D015996:Survival Rate
D010844:Picibanil; D018719:Erb-b2 Receptor Tyrosine Kinases; D011987:Receptors, Steroid