Abstract
BackgroundSurgery is becoming more practical and effective than conservative treatment in improving the poor outcomes of patients with breast cancer liver metastasis (BCLM). However, there is no generally acknowledged set of standards for identifying BCLM candidates who will benefit from surgery.MethodsBetween January 2011 and September 2018, 67 female BCLM patients who underwent partial hepatectomy were selected for analysis in the present study. Prognostic factors after hepatectomy were determined. Univariate and multivariate analyses were performed to identify predictors of overall survival (OS) and intrahepatic recurrence-free survival (IHRFS).ResultsThe 1-, 3- and 5-year OS of patients treated with surgery was 93.5%, 73.7% and 32.2%, respectively, with a median survival time of 57.59 months. The Pringle manoeuvre [hazard radio (HR) = 0.117, 95% CI0.015–0.942, p = 0.044] and an increased interval between breast surgery and BCLM diagnosis (HR0.178, 95% CI 0.037–0.869, p = 0.033) independently predicted improved overall survival for BCLM patients. The 1-, 2- and 3-year IHRFS of patients who underwent surgery was 62.8, 32.6% and 10.9%, respectively, with a median intrahepatic recurrence-free survival time of 13.47 months. Moderately differentiated tumours (HR 0.259, 95% CI 0.078–0.857, p = 0.027) and the development of liver metastasis more than 2 years after breast surgery (HR 0.270, 95% CI 0.108–0.675, p = 0.005) might be predictors of increased IHRFS.ConclusionsAn interval of more than 2 years between breast cancer surgery and liver metastasis seems to be an indication of liver surgery in BCLM patients. The Pringle manoeuvre and moderately differentiated tumours are potential predictors associated with OS and IHRFS, respectively, as benefits from liver resection. Studies with increased sample sizes are warranted to validate our results.
Highlights
Breast cancer is the largest contributor to mortality from malignant disease among women worldwide[1]
Overall survival (OS) time was defined as the time between liver surgery and death, while intrahepatic recurrence-free survival (IHRFS) time was defined as the time between liver surgery and recurrence in the liver
Consistent with previous investigations[9], our data demonstrated that the 5-year overall survival (OS) for the breast cancer liver metastasis (BCLM) patient cohort was as high as Overall survival based on the interval between breast surgery and liver metastasis diagnosis. d Overall survival based on the use of hepatic portal triad clamping
Summary
Breast cancer is the largest contributor to mortality from malignant disease among women worldwide[1]. Patients with breast cancer and liver metastasis (BCLM) have a median survival time of only 4–8 months. Results The 1-, 3- and 5-year OS of patients treated with surgery was 93.5%, 73.7% and 32.2%, respectively, with a median survival time of 57.59 months. The Pringle manoeuvre [hazard radio (HR) = 0.117, 95% CI0.015–0.942, p = 0.044] and an increased interval between breast surgery and BCLM diagnosis (HR0.178, 95% CI 0.037–0.869, p = 0.033) independently predicted improved overall survival for BCLM patients. The 1-, 2- and 3-year IHRFS of patients who underwent surgery was 62.8, 32.6% and 10.9%, respectively, with a median intrahepatic recurrence-free survival time of 13.47 months. Differentiated tumours (HR 0.259, 95% CI 0.078–0.857, p = 0.027) and the development of liver metastasis more than 2 years after breast surgery (HR 0.270, 95% CI 0.108–0.675, p = 0.005) might be predictors of increased IHRFS. Studies with increased sample sizes are warranted to validate our results
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