Liver resection for breast cancer metastasis: does it improve survival?
OBJECTIVE
To assess the outcome and prognostic factors of liver surgery for breast cancer metastasis.


METHODS
We retrospectively examined 16 patients who underwent partial liver resection for breast cancer liver metastasis (BCLM). All patients had been treated with chemotherapy or hormonotherapy, or both, before referral for surgery. We confirmed by preoperative radiological examinations that metastasis was confined to the liver. The survival curve was estimated using the Kaplan-Meier method. Univariate and multivariate analysis were conducted to evaluate the role of the known factors of breast cancer survival.


RESULTS
The median age of the patients was 54 years (range 38-68) and the median disease-free interval between the diagnoses of breast cancer and liver metastasis was 54 months (range 7-120). Nine major and 7 minor hepatectomies were performed. There was no postoperative death. The overall 1-, 3-, and 5-year survival rates were 94%, 61%, and 33%, respectively. The median survival rate was 42 months. Univariate analysis revealed that hormone receptor status, number of metastases, a major hepatectomy, and a younger age were associated with a poorer prognosis. The survival rate was not influenced by the disease-free interval, grade or stage of breast cancer, or intraoperative blood transfusions. The number of liver metastases was identified as a significant independent factor of survival according to the Cox proportional hazard model (P = 0.04).


CONCLUSIONS
Liver resection, when done in combination with adjuvant therapy, can improve the prognosis of selected patients with BCLM.
Lubrano
Jean
J
Department of Digestive Surgery, Rouen University Hospital, Rouen, France.
Roman
Horace
H
Tarrab
Sophie
S
Resch
Benoit
B
Marpeau
Loïc
L
Scotté
Michel
M
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
D000970:Antineoplastic Agents