Hepatic resection for liver metastases as part of the "oncosurgical" treatment of metastatic breast cancer.
BACKGROUND
Metastatic breast cancer is considered an incurable disease despite new therapies. Recent studies suggest that liver resection associated with systemic treatment may improve patient survival.


METHODS
Patient selection criteria were: good performance status, the feasibility of a complete and safe surgical procedure, and absence of uncontrolled extrahepatic metastases. The information was collected prospectively and analyzed retrospectively from our database.


RESULTS
Between 1988 and 2006, 13 liver resections were performed in 12 patients owing to metastatic breast cancer. Two patients had synchronous metastases and ten metachronous metastases. One patient had extrahepatic bone metastases at the time of liver resection. Median follow-up was 35.9 months (range 12-113.4 months). Median age at liver resection was 58.4 years (range 36-76 years). Median hospital stay was 8 days (range 6-24 days); two patients had biliary leak but none died during the postoperative course. Seven patients (58.3%) developed hepatic recurrence. One-, 3-, and 5-year actuarial patient survival was 100%, 79%, and 33%, respectively. Patients who developed liver metastases within the first 24 months and after the first 24 months post-breast surgery had 1-, 3-, and 5-year actuarial patient survival of 100%, 0%, and 0% and 100%, 83%, and 60%, respectively (P < 0.025).


CONCLUSIONS
Liver resection for breast cancer liver metastases has an important role in the oncosurgical treatment of metastatic breast cancer with excellent 3-year survival.
Caralt
Mireia
M
Department of Hepatobiliopancreatic Surgery and Transplants, Hospital Universitari Vall d'Hebron, Paseo Vall d'Hebron119-129, Barcelona, 08035, Spain. mcaralt@vhebron.net
Bilbao
Itxarone
I
Cortés
Javier
J
Escartín
Alfredo
A
Lázaro
José Luís
JL
Dopazo
Cristina
C
Olsina
Jorge Juan
JJ
Balsells
Joaquim
J
Charco
Ramon
R
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome