Abstract
We have performed a retrospective study to evaluate whether surgical treatment is beneficial in patients with hepatic metastases from breast cancer. Between September 1985 and September 1998, 25 patients with hepatic metastases (14 solitary and 11 multiple), eight of whom had extrahepatic metastases, underwent hepatectomy. All of the detectable liver metastasis were resected in all of the cases. There were no severe postoperative complications. All but one of the patients received adjunctive polychemotherapy after the hepatectomy. After the hepatectomy, recurrent tumors were detected in 18 of the patients, being located in the liver in 12 (67%) of them. Overall, however, hepatectomy ensured that the liver was clinically recurrence-free for a median of 24 months (range 2–132 months). Eleven patients died of recurrent tumors, two died of other causes and the remaining 12 are currently alive. The 2- and 5-year cumulative survival rates after hepatectomy were 71% and 27%, respectively, and the median survival duration was 34.3±3.2 months, much better than the period of 8.5 months for another series of patients treated with standard or non-surgical therapies at our institution. The number and the size of hepatic metastases, the interval between treatment of the primary lesion and hepatectomy, and the existence of extrahepatic metastasis were not adverse prognostic factors. In conclusion, our data, although limited and highly selective, suggest that surgical treatment of hepatic metastases from breast cancer may prolong survival in certain subgroups of patients to a greater extent than standard or non-surgical therapies.
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Cutler SJ, Asire AJ, Taylor SG: Classification of patients with disseminated cancer of the breast. Cancer 24: 861–869, 1969
Inoue K, Ogawa M, Horikoshi N, Aiba K, Mukaiyama T, Mizunuma N, Itami S, Hirano A, Matsuoka A, Matsunuma T: Evaluation of prognostic factors for 233 patients with recurrent advanced breast cancer. Jpn J Clin Oncol 21: 334–339, 1991
Hoe AL, Royle GT, Taylor I: Breast liver metastases - incidence, diagnosis and outcome. J Roy Soc Med 84: 714–716, 1991
O'Reilly SM, Richards MA, Rubins RD: Liver metastases from breast cancer: the relationship between clinical, biological and pathological features and survival. Eur J Cancer 26: 574–577, 1990
Smalley RV, Carpenter T, Bartolucci A, et al.: A comparison of cyclophosphamide, adriamycin, 5-fluorouracil (CAF) and cyclophosphamide, methotrexate, 5-fluorouracil vincristine, prednisone (CMFVP) in patients with metastatic breast carcinoma. Cancer 40: 625–632, 1977
Petrek JA, Milton JP: Treatment of hepatic metastases by percutaneous hepatic arterial infusion. Cancer 43: 2182–2188, 1979
Pets M, Swanson J, Moseley HS, Fletcher WS: Endocrine ablation and hepatic artery infusion in the treatment of metastases to liver from carcinoma of the breast. SGO 155: 395–400, 1982
Fraschini G, Fleishman G, Charnsangavej C, et al.: Continuous 5-day infusion of vinblastine for percutaneous hepatic arterial chemotherapy for metastatic breast cancer. Cancer Treat Rep 71: 1001–1005, 1988
Okino T, Kan N, Nakanishi M, et al.: The therapeutic effect of OK-432-combined adoptive immunotherapy against liver metastases from breast cancer. J Cancer Res Clin Oncol 116: 197–202, 1990
Elias D, Lasser P, Spielmann M, May-Levin F, Malt OE, Thomas H, Mouriesse H: Surgical and chemotherapeutic treatment of hepatic metastases. SGO 172: 461–464, 1991
Elias D, Lasser PH, Montrucolli D, Bonvallot S, Spielmann M: Hepatectomy for liver metastases from breast cancer. Eur J Surg Oncol 21: 510–513, 1995
Raab R, Nussbaum KT, Werner U, Pichlmayr R: Lebermetastasen bei Mammacacinom. Chirurg 67: 234–237, 1996
Stehlin JS, Ipolyi PD, Greeff PJ, McGaff CJ, Davis BR, McNary L: Treatment of cancer of the liver. Ann Surg 208: 23–35, 1988
Mariette D, Fagneiz PL: Liver metastases from non-colorectal cancers. Results and surgical treatment. Rev Prat 42: 1271–1275, 1992
Schneebaum S, Walker MJ, Young D, Farrar WB, Milton JP: The regional treatment of liver metastases from the breast cancer. J Surg Oncol 55: 26–32, 1994
Foster JH: Survival after liver resection for secondary tumors. Am J Surg 135: 389–394, 1978
Lorenz M,Weisner J, Staib-Sebler E, Encke A: Regional Therapie von Mammakarzinom-Lebermetastasen. Zentrabl Chir 120: 786–790, 1995
Yoshimoto M, Iwase T, Watanabe S, Kasumi F, Saeki K, Akiyama F, Sakamoto G: Successful treatment for an advanced breast cancer patient with multiple liver metastasis localized to the left lobe. Oncologia 24: 121–125, 1991
Martì nez A, Sánchez M, Roselló R, Seltzer R, Alonso C and Andrés L: Ultrasonic patterns observed in hepatic metastases from breast carcinoma: Diagnosis and evolution. Gastrointest Radiol 14: 49–54, 1989
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Yoshimoto, M., Tada, T., Saito, M. et al. Surgical treatment of hepatic metastases from breast cancer. Breast Cancer Res Treat 59, 177–184 (2000). https://doi.org/10.1023/A:1006398401352
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DOI: https://doi.org/10.1023/A:1006398401352