title: Systematic review of early and long-term outcome of liver resection for metastatic breast cancer: Is there a survival benefit?
abstract: BACKGROUND
  Isolated liver metastases occur rarely in patients with metastatic breast cancer. The success of liver resection (LR) for other metastatic disease has led centres to explore the option of LR for patients with isolated breast cancer liver metastases (BCLM). A number of small series have been published in the literature, however the evidence is conflicting. This study aimed to systematically review the literature to determine the perioperative outcome and survival of patients undergoing LR for BCLM.
  
  
  METHODS
  An electronic search of Medline and Embase databases was performed to identify all published series. Patient demographics, management, peri-operative outcome and overall survival (OS) were obtained.
  
  
  RESULTS
  A total of 1705 articles were identified of which 531 included patients with non-colorectal and non-neuroendocrine metastases. 43 articles including 1686 patients, met all the inclusion and exclusion criteria. R0 resection was achieved in 83% (683/825). Morbidity and 30-day mortality rates were 20% (174/852) and 0.7% (6/918), respectively. The median OS was 36 months (12-58 months). The median 1-, 3-and 5-year OS were 90%, 56% and 37%, respectively.
  
  
  CONCLUSIONS
  LR for BCLM can be carried out with acceptable peri-operative risks in selected patients with survival outcomes that appear to be superior to chemotherapy alone.
authors.affiliation: Department of Surgery, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand. Electronic address: taegon51@hotmail.com.
authors.forename: Tae Gon
authors.initials: TG
authors.lastname: Yoo
authors.affiliation: Breast Unit, Department of General Surgery, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1023, New Zealand.
authors.forename: Isaac
authors.initials: I
authors.lastname: Cranshaw
authors.affiliation: Department of Medical Oncology, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1023, New Zealand.
authors.forename: Reuben
authors.initials: R
authors.lastname: Broom
authors.affiliation: Department of Surgery, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand; HPB/UGI Unit, Department of General Surgery, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1023, New Zealand.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Pandanaboyana
authors.affiliation: Department of Surgery, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand; HPB/UGI Unit, Department of General Surgery, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1023, New Zealand.
authors.forename: Adam
authors.initials: A
authors.lastname: Bartlett
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Breast cancer; Chemotherapy; Liver resection; Metastatic disease