title: Prognostic factors for longer disease free survival and overall survival after surgical resection of isolated liver metastasis from breast cancer.
abstract: OBJECTIVE
  Isolated liver metastases (LMs) from breast cancer (BC) occur in only 1-3% of the cases. Resection of isolated LMs improves survival. We examined the prognostic factors for time to LM development, disease free survival (DFS) and overall survival (OS) after BCLM resection.
  
  
  METHODS
  From 2006 to 2009, 32 patients underwent LM resection. All of them had breast cancer surgery for their primary tumor and developed resectable LMs as the first and only site of disease progression.
  
  
  RESULTS
  LMs developed after a median of 25 months. With a median follow up of 37 months (range 7-66) after metastases resection, median DFS and OS (with 95% CI) were 22.5 (12-40) and 37 (≥23) months, respectively. Tumor size ≥3 vs <3 cm and adjuvant chemotherapy vs no adjuvant chemotherapy correlated with shorter time to LM development (p<0.01 for both parameters). These parameters and BC negative estrogen (ER)/ progesterone receptors (PR) (ER?/PR? vs other) were related with shorter DFS. Positive (vs negative) axillary lymph nodes and BC negative ER/ PR (ER?/PR? vs other) status correlated with shorter OS (p<0.01 for both parameters). A period to metastases development ≥ 24 months (vs ≤24) and single (vs multiple) metastases were related with longer DFS and OS (p<0.01 for both conditions).
  
  
  CONCLUSIONS
  Despite the relatively small number of patients in this study, we believe that positive ER/PR status for both BC and LMs, negative axillary lymph nodes, time to liver metastases development >24 months and single liver metastases predict longer DFS and OS after LM resection.
authors.affiliation: Clinic of Surgical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
authors.forename: M
authors.initials: M
authors.lastname: Zegarac
authors.forename: S
authors.initials: S
authors.lastname: Nikolic
authors.forename: D
authors.initials: D
authors.lastname: Gavrilovic
authors.forename: M
authors.initials: M
authors.lastname: Jevric
authors.forename: D
authors.initials: D
authors.lastname: Kolarevic
authors.forename: Z
authors.initials: Z
authors.lastname: Nikolic-Tomasevic
authors.forename: M
authors.initials: M
authors.lastname: Kocic
authors.forename: I
authors.initials: I
authors.lastname: Djurisic
authors.forename: Z
authors.initials: Z
authors.lastname: Inic
authors.forename: V
authors.initials: V
authors.lastname: Ilic
authors.forename: N
authors.initials: N
authors.lastname: Santrac
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008408:Mastectomy; D059146:Metastasectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone