Resection of liver metastases in patients with breast cancer: survival and prognostic factors.
OBJECTIVE
Patients with breast cancer metastasized to the liver have a median survival of 4-33 months and treatment options are usually restricted to palliative systemic therapy. The aim of this observational study was to evaluate the effectiveness and safety of resection of liver metastases from breast cancer and to identify prognostic factors for overall survival.


METHODS
Patients were identified using the national registry of histo- and cytopathology in the Netherlands (PALGA). Included were all patients who underwent resection of liver metastases from breast cancer in 11 hospitals in The Netherlands of the last 20 years. Study data were retrospectively collected from patient files.


RESULTS
A total of 32 female patients were identified. Intraoperative and postoperative complications occurred in 3 and 11 patients, respectively. There was no postoperative mortality. After a median follow up period of 26 months (range, 0-188), 5-year and median overall survival after partial liver resection was 37% and 55 months, respectively. The 5-year disease-free survival was 19% with a median time to recurrence of 11 months. Solitary metastases were the only independent significant prognostic factor at multivariate analysis.


CONCLUSIONS
Resection of liver metastases from breast cancer is safe and might provide a survival benefit in a selected group of patients. Especially in patients with solitary liver metastasis, the option of surgery in the multimodality management of patients with disseminated breast cancer should be considered.
Department of Surgery, TweeSteden Hospital, Tilburg, The Netherlands. gamvanwalsum@gmail.com
G A M
GA
van Walsum
J A M
JA
de Ridder
C
C
Verhoef
K
K
Bosscha
T M
TM
van Gulik
E J
EJ
Hesselink
T J M
TJ
Ruers
M P
MP
van den Tol
I D
ID
Nagtegaal
M
M
Brouwers
R
R
van Hillegersberg
R J
RJ
Porte
A M
AM
Rijken
L J A
LJ
Strobbe
J H W
JH
de Wilt
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D017115:Catheter Ablation / Q000379:methods / Q000401:mortality; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome