The Role of Liver-Directed Surgery in Patients With Hepatic Metastasis From Primary Breast Cancer: a Multi-Institutional Analysis

• Autor(a) principal: Margonis, GA
• Data de Publicação: 2016
• Outros Autores: Buettner, S, Sasaki, K, Kim, Y, Ratti, F, Russolillo, N, Ferrero, A, Berger, N, Gamblin, TC, Poultsides, G, Tran, T, Postlewait, LM, Maithel, S, Michaels, AD, Bauer, TW, Pinto Marques, H, Barroso, E, Aldrighetti, L, Pawlik, TM
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3004
• topic: Aged; Breast Neoplasms; Databases, Factual; Female; Humans; Italy; Kaplan-Meier Estimate; Liver Neoplasms; Margins of Excision; Metastasectomy; Middle Aged; Multivariate Analysis; Portugal; Proportional Hazards Models; Risk Factors; Time Factors; Treatment Outcome; Tumor Burden; United States; Hepatectomy; CHLC CHBPT

BACKGROUND: Data on surgical management of breast liver metastasis are limited. We sought to determine the safety and long-term outcome of patients undergoing hepatic resection of breast cancer liver metastases (BCLM). METHODS: Using a multi-institutional, international database, 131 patients who underwent surgery for BCLM between 1980 and 2014 were identified. Clinicopathologic and outcome data were collected and analyzed. RESULTS: Median tumor size of the primary breast cancer was 2.5 cm (IQR: 2.0-3.2); 58 (59.8%) patients had primary tumor nodal metastasis. The median time from diagnosis of breast cancer to metastasectomy was 34 months (IQR: 16.8-61.3). The mean size of the largest liver lesion was 3.0 cm (2.0-5.0); half of patients (52.0%) had a solitary metastasis. An R0 resection was achieved in most cases (90.8%). Postoperative morbidity and mortality were 22.8% and 0%, respectively. Median and 3-year overall-survival was 53.4 months and 75.2%, respectively. On multivariable analysis, positive surgical margin (HR 3.57, 95% CI 1.40-9.16; p = 0.008) and diameter of the BCLM (HR 1.03, 95% CI 1.01-1.06; p = 0.002) remained associated with worse OS. DISCUSSION: In selected patients, resection of breast cancer liver metastases can be done safely and a subset of patients may derive a relatively long survival, especially from a margin negative resection.