Liver resection for breast cancer metastasis: Does it improve survival?

Lubrano, Jean; Roman, Horace; Tarrab, Sophie; Resch, B.; Marpeau, L.; Scotté, Michel

doi:10.1007/s00595-007-3617-2

Cited by 79 publications

(76 citation statements)

References 26 publications

(41 reference statements)

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“…In the study by Elias [24], hormone receptor status was a positive factor, but this was refuted by several other studies [20,26,31,35]. In contrast, presence of hormone receptors in the primary BC as well as in BCLM had a negative influence in the study by Lubrano [36].…”

Section: Studies Of Liver Resection (N=25)contrasting

confidence: 37%

“…Interval between primary BC and BCLM was a positive factor in the studies by Selzner, Pocard, and Caralt [20,22,37] but not so in several other studies [21,24,26,27,31,35,36]. Size, site or number of BCLM were not generally found to be of significance, except that >1 BCLM was a negative factor in one study [23] (table 2).…”

Section: Studies Of Liver Resection (N=25)mentioning

confidence: 99%

“…Except for one study [36], the execution of liver surgery in terms of major vs. minor resections was generally not of significance [20,22,26,27,31] (table 2). Repeat hepatectomy was found to be a positive factor for survival by Adam [31].…”

Section: Studies Of Liver Resection (N=25)mentioning

confidence: 99%

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Liver resection and local ablation of breast cancer liver metastases – A systematic review

Bergenfeldt

Jensen

Skjoldbye

et al. 2011

European Journal of Surgical Oncology (EJSO)

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Aim : To analyze surgical treatment of breast cancer liver metastases (BCLM) regarding selection criteria, outcome and prognostic parameters.Methods : We searched Embase and Medline for all studies published 1999-2010.Results : Resection was associated with a median survival (MOS) of 20-67 months and 5-year survival of 21-61%. Local ablation also had a favourable outcome; MOS was 30-60 months and and 5-year survival 27-41%. Regarding selection, no specific limits regarding the number and size of BCLM can be given. Features of the primary breast cancer (BC) was not significant for the prognosis. Microscopically radical (R0) resection is a positive prognostic factor, while the effects of disease interval, hormone receptor status and response to preoperative chemotherapy were divergent. The presence of EHD had a negative effect on survival in some studies, but failed to have so in other studies.Conclusions: Surgical therapy may benefit a subset of patients with BCLM. Resection may be indicated, if an RO-resection can be done with a low risk of mortality. Liver resection in the presence of extrahepatic disease remains controversial, while patients with BCLM and bone metastases could possibly be managed differently than other EHD.

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Section: Studies Of Liver Resection (N=25)contrasting

confidence: 37%

Section: Studies Of Liver Resection (N=25)mentioning

confidence: 99%

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Liver resection and local ablation of breast cancer liver metastases – A systematic review

Bergenfeldt

Jensen

Skjoldbye

et al. 2011

European Journal of Surgical Oncology (EJSO)

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“…Apart from the detection of recurrence, other advantages of this approach include the low cost of tumour marker testing and the decrease in radiation burden incurred by patients when radiodiagnostic methods such as CT or PET CT alone are used to diagnose recurrence. Tumour markers are also important indicators of the efficacy of oncological treatment of this disease (23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

Třeška¹,

Topolčan²,

Zoubkova³

et al. 2018

Anticancer Res

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Abstract. Background RFS (p<0.04; p<0.01; p<0.02), while CA19-9 postoperative levels were significant for OS and RFS (p<0.03; p<0.01 Breast cancer (BC) represents the most frequent cancer worldwide among women and is one of the most frequent causes of death in this population. BC metastases either develop concomitantly with the primary BC or at different time intervals in more than 50% of women with BC. Breast cancer liver metastases (BCLM) in most women are associated with concurrent BC dissemination to the lungs and bones and these represent the only site of metastatic BC in 12-15% women. Although great progress has been made in the diagnosis and effective treatment of BC, metastases develop in 30% of women despite timely diagnosis and radical treatment (1, 2).Surgical treatment of BCLM is an important component of multimodal therapeutic approaches. However, its results remain suboptimal compared, for example, to patients with colorectal cancer liver metastases. In our view, one strategy that might improve the results of surgical management of BCLM is the search for early indicators of tumour dissemination or for prognostically high-risk patients.Tumour markers are general indicators used in monitoring and follow-up of patients. The most frequently used markers to monitor treatment efficacy and diagnose BCLM recurrence include mucins, such as carbohydrate antigen CA 19-9, cytokeratins such as tissue polypeptide antigen (TPA) and tissue-specific polypeptide antigen (TPS), proliferation markers such as thymidine kinase (TK) and carcinoembryonic antigen (CEA). However, no study regarding the prognostic significance of preoperative serum tumour marker levels in patients undergoing surgery for BCLM has been published to date, as far as we are aware.The aim of our retrospective study was to determine whether perioperative levels of clinically routinely used tumour markers influence overall survival (OS) and recurrence-free survival (RFS) of patients undergoing resection or thermoablative therapy for BCLM as part of a multimodal approach. Patients and MethodsFrom January 1, 2000 until January 1, 2018, a total of 32 women underwent surgery for BCLM at the Department of Surgery, University Hospital in Pilsen, Czech Republic. Surgery was indicated in women in a general good state of health from the aspect of surgery and those who had consented to undergo the proposed surgical procedure. Surgery was indicated only if the metastases were located solely within the liver parenchyma. Every patient underwent hybrid imaging using positron-emission tomography (PET) and computed tomography (CT) or PET and magnetic resonance imaging (MRI) before surgery. Another requirement was that the future liver remnant volume exceed 30% of the total liver volume. The average age of these women was 49.5±10.7 years. The primary BC types were: ductal in 20 cases, lobular in seven, erysipeloid in four, and sarcomatoid (spindle cell) carcinoma in one. The average interval between initial breast surgery and BCLM surgery was 4.7±3.7 years.

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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%

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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Liver resection for breast cancer metastasis: Does it improve survival?

Abstract: Liver resection, when done in combination with adjuvant therapy, can improve the prognosis of selected patients with BCLM.

Cited by 79 publications

References 26 publications

Liver resection and local ablation of breast cancer liver metastases – A systematic review

Liver resection and local ablation of breast cancer liver metastases – A systematic review

Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

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

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