An attempt to clarify indications for hepatectomy for liver metastases from breast cancer

Élias, Dominique; Maisonnette, F.; Druet‐Cabanac, Michel; Ouellet, Jean Francois; Guinebretière, Jean Marc; Spielmann, M.; Delaloge, Suzette

doi:10.1016/s0002-9610(02)01204-7

Cited by 162 publications

(147 citation statements)

References 19 publications

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“…Gregory et al 11 demonstrated that the median survival of patients with secondary liver metastasis from primary breast cancer following chemotherapy was 4.5 months, and even treatment with agents such as docetaxel may only improve survival to 9-14.7 months. 12,13 Following hepatic resection for metastatic breast cancer, 3-year survival rates of 49-53% 5,6,14 and 5-year survival rates of 18-34% have been reported. 4,14,15 However, recurrent disease is commonly seen in these patients, being detected in all of those followed for >1y ear in one study 5 and 63% of survivors at 3 years in another.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation (RFA) as A Cytoreductive Strategy for Hepatic Metastasis from Breast Cancer

Lawes

Chopada

Gillams

et al. 2006

annals

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INTRODUCTION Patients with liver metastasis from breast cancer have a poor prognosis, although this may be improved by hepatectomy in a selected group with disease confined to the liver. We evaluate the effectiveness of radiofrequency ablation (RFA) as a cytoreductive strategy in the management of liver metastasis from primary breast cancer.PATIENTS AND METHODS Nineteen patients with hepatic metastasis from primary breast cancer underwent RFA of their liver lesions between April 1998 and August 2004. RESULTS The median age of the patients was 52 years (range, 32-69 years), 8 had disease confined to the liver, with 11 having stable extrahepatic disease in addition. Seven patients with disease confined to the liver at presentation are alive, as are 6 with extrahepatic disease, median follow-up after RFA was 15 months (range, 0-77 months). Survival at 30 months was 41.6%. In addition, 7 patients followed up for a median of 14 months (range, 2-29 months) remain alive and disease-free. RFA failed to control hepatic disease in 3 patients. RFA was not associated with any mortality or major morbidity.CONCLUSIONS Control of hepatic metastasis from breast cancer is possible using RFA and may lead to a survival benefit, particularly in those patients with disease confined to the liver. KEYWORDSLiver metastasis -Radiofrequency ablation (RFA) -Breast cancer

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Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation (RFA) as A Cytoreductive Strategy for Hepatic Metastasis from Breast Cancer

Lawes

Chopada

Gillams

et al. 2006

annals

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“…While radiotherapy is quite common in patients with symptomatic metastatic disease, the benefit of surgical resection of distant metastases is still a matter of debate due to the systemic character of the disease, and despite some encouraging reports, especially from patients with hepatic and pulmonary disease. [18][19][20] To combine local with intensified systemic treatment, we initiated the pilot trial presented here with dose-intensive induction chemotherapy, peripheral-blood stem-cell collection, local treatment in combination with infusional 5-FU plus folinic acid, and two subsequent courses of HDC. The addition of infusional 5-FU plus folinic acid to local treatment was used for better systemic control based on encouraging results of this schedule even in anthracyclineresistant disease.…”

Section: Discussionmentioning

confidence: 99%

High-dose chemotherapy with autologous stem cell transplantation in patients with oligometastatic breast cancer

Bojko

Welt

Schleucher

et al. 2004

Bone Marrow Transplant

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Summary:The purpose of this prospective trial was to study a combined-modality treatment including local consolidation by surgery or radiotherapy and high-dose chemotherapy (HDC) followed by peripheral-blood stem-cell (PBSC) transplantation. In all, 48 patients with oligometastatic breast cancer amenable to local treatment after induction chemotherapy with epirubicin and cyclophosphamide or paclitaxel and cisplatin, depending on prior adjuvant chemotherapy, were enrolled. The median follow-up was 41 months (range, 7-85 months). PBSC were collected in 47 patients, and 40 received one or two courses of HDC. Local therapy was given in 37 patients. No treatment-related deaths occurred. Of 47 evaluable patients, 36 (75% of intention-to-treat population) had no evidence of disease or complete remission after completion of therapy. Six patients (12.5%) had partial response, two patients (4%) no change, and three patients (6%) progressive disease. The median time to progression and overall survival was 17.5 (95% confidence interval (CI), 14-21 months) and 42.2 months (95% CI, 33-52 months), respectively, and 27% of patients were progression free after 5 years. In conclusion, patients with oligometastatic breast cancer can be treated safely with this combined modality protocol with promising relapse-free survivals.

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“…In the most recent and representative case studies series, resection of breast cancer liver metastases shows that the appearance of metastases follows the discovery of the primary tumor of an average of 40 months (23-77), the indication for resection concerns cases with single lesion or a maximum of two lesions, with dimensions within 3 cm in most cases, and that in most cases, major resections were performed (more than 3 liver segments) with values of radical resection (negative margin resection) of more than 80% [118][119][120][121][122][123][124][125]. The average survival values reported by these series range from 32 to 74 months and the 5-year follow-up survival rates are of 34-80%.…”

Section: Liver Metastases From Breast Cancermentioning

confidence: 99%

“…It is evident from many series that survival is influenced by the state of the free margin, although not always the gap between R0 and R1 leads to a robust statistical difference [122]. Therefore, considering the possibility of a chemotherapy response and the greater possibility of surgical treatment also linked to the impact of new intraoperative technologies (e.g., radio frequency and microwave), it seems natural to expect in the immediate future an expansion of the surgical indications for breast cancer liver metastasis.…”

Section: Liver Metastases From Breast Cancermentioning

confidence: 99%

Surgical Indications, Timing, and Strategy in Non-colorectal Liver Metastases

Uzzau¹,

Bertozzi²,

Londero³

et al. 2015

Recent Advances in Liver Diseases and Surgery

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Taking into consideration all primary solid tumors, the liver represents the most common site involved in distant metastasization, also due to its important blood reception from the majority of digestive organs. Despite the abundant literature and guidelines about colorectal liver metastases, there is still great debate about the treatment strategy in the case of non-colorectal ones. Therefore, in this chapter, we reviewed the treatment strategy and surgical indications for the most frequent non-colorectal liver metastases. In the case of neuroendocrine hepatic secondaries, the literature suggests that surgery should be always considered for patients with resectable hepatic disease, as this treatment results more likely to offer the best long-term outcome. For what concerns liver metastases from gastric cancer, surgical approach should always be undertaken if indications are appropriate, after a multidisciplinary discussion to plan an adequate multidisciplinary adjuvant treatment, a proper patient selection, and the exclusion of additional secondary tumors or extrahepatic metastases. Taking into consideration liver secondaries from breast cancer and their chemosensitivity, in the absence of brain and lung lesions, it can be considered a space for liver surgery, especially in the case of single lesions or a maximum of two lesions with dimensions within 3 cm. However, as the number of cancer survivors is progressively increasing and, with it, the number of patients affected by non-colorectal liver metastases, further randomized controlled trials are required in order to better define the benefit of hepatic surgery in these kinds of patients.

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An attempt to clarify indications for hepatectomy for liver metastases from breast cancer

Cited by 162 publications

References 19 publications

Radiofrequency Ablation (RFA) as A Cytoreductive Strategy for Hepatic Metastasis from Breast Cancer

Radiofrequency Ablation (RFA) as A Cytoreductive Strategy for Hepatic Metastasis from Breast Cancer

High-dose chemotherapy with autologous stem cell transplantation in patients with oligometastatic breast cancer

Surgical Indications, Timing, and Strategy in Non-colorectal Liver Metastases

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