Breast cancer liver metastases in a UK tertiary centre: Outcomes following referral to tumour board meeting

Abbas, Hiba; Erridge, Simon; Papoulas, M.; Nawaz, Amir; Menon, Krishna; Heaton, Nigel; Prachalias, Andreas; Srinivasan, Parthi

doi:10.1016/j.ijsu.2017.06.049

Cited by 21 publications

(19 citation statements)

References 34 publications

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“…We also found that survival was poorer among patients with more extensive systemic disease at diagnosis (P < 0.0001). Similarly, a few aforementioned studies also suggested that patients with liver-only metastatic disease may experience longer survival compared with patients harboring liver metastases in parallel with metastases in other organs (14,15,19,20,48). In a prospective, randomized phase III trial study of 304 women diagnosed with locally advanced (inoperable) or metastatic breast cancer, patients with liver-only metastatic disease experienced longer survival compared with patients harboring liver metastases in parallel with metastases in other organs [log-rank, P ¼ 0.01, multivariate Cox model P < 0.001 adjusting for age (>50 years or 50 years), metastasis-free interval ( 52 years or >2 years); ref .…”

Section: Discussionmentioning

confidence: 95%

“…In a retrospective review in 80 consecutive patients who were treated for breast cancer liver metastases, the presence of extrahepatic metastases was found to worsen prognosis in breast cancer liver metastases (HR ¼ 14.21; 95% CI, 1.08-186.94; P ¼ 0.044; ref. 19). As a result, treatment options for liver oligometastases include surgery or stereotactic radiotherapy may hold great value, and more randomized controlled trials are needed to investigate the efficacy of these treatments (14).…”

Section: Discussionmentioning

confidence: 99%

“…Population-based estimates for the prognosis in patients with newly diagnosed breast cancer and liver metastases are lacking. Data from several single institution experiences and retrospective studies (8,(16)(17)(18)(19)(20)(21)(22)(23) yielded varying results. Duan and colleagues (23) reported on the outcome of 123 patients with breast cancer diagnosed with liver metastases; they found subtype remained an independent prognostic predictor among patients with breast cancer liver metastases, in which triplenegative breast cancer (TNBC) conferred the worst survival after diagnosis of liver metastases when compared with non-triplenegative subtypes.…”

Section: Introductionmentioning

confidence: 99%

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A Population-Based Study on Liver Metastases in Women with Newly Diagnosed Breast Cancer

Xie

2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Population-based estimates for prognosis among patients with liver metastases in newly diagnosed breast cancer are not generally available.Methods: Within the Surveillance, Epidemiology and End Results (SEER) database, we identified 298,370 patients with breast cancer and 4,285 patients diagnosed with initial liver metastases between 2010 and 2014. Data were stratified according to subtype, age, and race. Multivariate logistic and Cox regression were used to identify predictors for the presence of initial liver metastases and prognostic factors, respectively. Kaplan-Meier procedure was used for survival analysis.Results: A total of 4,285 patients with initial liver metastases (1.4% of the entire cohort, 29.6% of the subset with metastatic disease) were identified. Patients with hormone receptor (HR)-negative human epidermal growth factor receptor 2 (HER2)-positive (4.4% of entire cohort, 52.5% of patients with metastatic disease to any distant site) and HR-positive HER2-positive (2.8% of entire cohort, 40.4% of patients with metastatic disease to any distant site) subtypes had highest incidence proportions. The median survival of patients with liver metastases in the entire cohort was 15.0 months. Patients with HR-positive HER2-positive subtype showed the longest median survival (31.0 months); however, patients with triplenegative subtype showed the shortest median survival (8.0 months).Conclusions: Our findings provide population-based estimates of epidemiologic characteristics and prognosis in breast cancer patients diagnosed with initial liver metastases.Impact: This study lends support to the diagnosis of the liver among patients at high risk of liver metastases, including those with HER2-positive and other systemic metastases.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Population-Based Study on Liver Metastases in Women with Newly Diagnosed Breast Cancer

Xie

2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…A previous study including 104 BCLM patients concluded that there was no impact of breast cancer subtypes on the survival after hepatic metastases [15]. A single center study of British population also presented similar results [16]. HER2 positive breast cancer is associated with a more aggressive phenotype and worse prognosis.…”

Section: Introductionmentioning

confidence: 75%

Risk and prognostic factors of breast cancer with liver metastases

Liu

Zhu

et al. 2020

Preprint

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Background: Liver metastasis is a significant adverse predictor of overall survival (OS) among breast cancer patients. The purpose of this study was to determine the risk and prognostic factors of breast cancer with liver metastases (BCLM). Methods: Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were included. Logistic regression was used to identify risk factors for liver metastasis. Cox proportional hazards regression model was adopted to determine independent prognostic factors in BCLM patients.Results: Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+) were risk factors for developing liver metastasis. The median OS after liver metastasis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. Molecular subtypes also played a critical role in the survival of BCLM patients. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS (38.0 for SEER vs. 34.0months for FUSCC), whereas triple-negative breast cancer had the shortest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR)=2.62; 95% confidence interval (CI)= 1.88-3.66; P<0.001) and HR-/HER2+ (HR=3.43; 95% CI=2.28-5.15; P<0.001) were associated with a significantly increased death risk in comparison with HR+/HER2- patients if these patients did not receive HER2-targeted therapy. For those who underwent HER2-targeted therapy, however, HR+/HER2+ subtype reduced death risk compared with HR+/HER2- subtype (HR=0.74; 95% CI=0.58-0.95; P<0.001).Conclusions: Breast cancer patients at a high risk for developing liver metastasis deserve more attention during the follow-up. BCLM patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative patients due to the introduction of HER2-targeted therapy and therefore it should be recommended for HER2+ BCLM patients.

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“…Patients with primary metastatic diseases have poorer prognosis and benefit less from hepatectomy than those in whom liver metastasis occur more than one year after breast cancer diagnosis [5,8,9]. Despite related criteria of selection of the candidates for hepatectomy in MBC, a few single institution studies report favorable initial results in patients with more than one liver metastases, and more than that, even perform re-resection of hepatic metastases derived from BC [10,11].…”

Section: Discussionmentioning

confidence: 99%

Breast cancer with intraabdominal metastases. Is surgery necessary?

Panuţa¹,

Radu²,

Huțanu³

et al. 2018

Arch Clin Cases

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Metastatic breast cancer has a very poor prognosis, considering the lack of reliable curative medical or surgical approaches. Patients with stage IV breast cancer usually undergo palliative surgical procedures and symptomatic treatment. In a 5-year period, 1258 patients with breast cancer were treated in our surgical oncology unit. For the current study, we have selected 19 (1.43%) female patients with intraabdominal metastases (peritoneal, hepatic, ovarian etc.) derived from breast cancer, which received at least one surgical procedure in our unit. We compared our data with up-to-date reports and guidelines in order to establish the role and further directions of surgery, and (most importantly) the necessity of surgery itself in the management of this therapeutically disadvantaged patient-group. Even if current guidelines do not recommend surgical treatment of intraabdominal metastases derived from breast cancer, several oncology centers (including our unit) did not discard surgery, especially in patients with solitary metastasis.

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Breast cancer liver metastases in a UK tertiary centre: Outcomes following referral to tumour board meeting

Abstract: Surgical resection of BCLM may improve the overall survival in selected patient groups. This study identifies a cohort of patients, without extrahepatic disease and responsive to chemotherapy, who may particularly benefit from surgery.

Cited by 21 publications

References 34 publications

A Population-Based Study on Liver Metastases in Women with Newly Diagnosed Breast Cancer

A Population-Based Study on Liver Metastases in Women with Newly Diagnosed Breast Cancer

Risk and prognostic factors of breast cancer with liver metastases

Breast cancer with intraabdominal metastases. Is surgery necessary?

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