Prognostic factors for patients with hepatic metastases from breast cancer

Wyld, Lynda; Gutteridge, E.; Pinder, Sarah; James, Jonathan; Chan, Sy; Cheung, Kwok-Leung; Robertson, J. F. R.; Evans, Andrew

doi:10.1038/sj.bjc.6601038

Cited by 183 publications

(149 citation statements)

References 28 publications

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“…It is difficult to know whether this reflects differences in treatment, or the increased likelihood of dying from other conditions. We have seen a similar trend for worsening survival in our elderly patients with liver metastases, which seems in part explained by differences in treatment, with only 6.4% receiving chemotherapy compared to 56% of patients under 70 years (Wyld et al, 2002). Death from comorbid conditions has been put forward as an argument for the apparent poor survival in individuals over 70 years of age (Yanick et al, 2001).…”

Section: Discussionsupporting

confidence: 58%

Bone metastases from breast carcinoma: histopathological – radiological correlations and prognostic features

et al. 2003

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The aim of this study was to identify factors that may be associated with the development of bone metastases in patients with metastatic breast carcinoma and to see if any of these factors had a bearing on subsequent survival. In total, 492 patients presented to the Nottingham City Hospital with metastatic breast carcinoma between July 1997 and December 2001. Of these, 267 patients had bone metastases at presentation with metastatic disease, 91 patients in this group had bone as their only site of metastatic disease. Sites of first presentation of metastatic disease were prospectively recorded, as were histological features of the primary tumour (tumour type, histological grade, lymph node stage, tumour size and oestrogen receptor (ER) status). The radiological features of the bone metastases, the metastasis-free interval and serological tumour marker levels at presentation with metastases were all recorded. There was a significant association between the development of bone metastases and lower grade tumours (P ¼ 0.019), ER-positive tumours (Po0.0001) and the lymph node stage of the primary tumour (P ¼ 0.047). A multivariate analysis found that metastasis-free interval, additional sites of metastatic disease other than bone, ER status and serological tumour marker levels all independently contributed to survival from time of presentation with bone metastases. British Journal of Cancer (2003) The survival of patients with metastases is variable ranging from a matter of months to many years. The ability to predict prognosis and response to treatment has a considerable impact on patient management. It is well established that oestrogen receptor (ER) status and site of presentation of metastatic disease have the greatest impact on patient survival, with additional contributions made by patient age, disease-free interval and histological grade.Bone is the most common site of metastases in patients with breast carcinoma and so patients with bone metastases make up the largest single group of patients presenting with metastatic disease. It has previously been reported that 20% of patients with bone metastases survive for more than 5 years, which emphasises the wide variation in survival seen in this group of patients (Coleman et al, 1987). The aim of this study was to identify factors that may be associated with the development of bone metastases and to see if any of these factors had any bearing on subsequent survival.We have assessed traditional factors such as ER status, histological grade, lymph node stage and size of the primary tumour, patient age, metastasis-free interval and the presence of metastases at sites other than bone. We have examined the radiological appearance of the bone metastases and looked for associations with the histological features of the tumour and patient survival. In common with other centres, we increasingly use serological tumour markers in the diagnosis and monitoring of patients with metastatic breast carcinoma. The prognostic significance of elevated tumour markers at presentation ...

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Section: Discussionsupporting

confidence: 58%

Bone metastases from breast carcinoma: histopathological – radiological correlations and prognostic features

et al. 2003

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“…In this study, hepatic metastases from breast cancer had a median survival time of 16.0 months which is similar to the results quoted by Wyld et al (Zinser et al, 1987;Wyld et al, 2003) and better than the findings of other studies (Patanaphan et al, 1988;O'Reilly et al, 1990;Hoe et al, 1991). On multivariate analysis in this study, hepatic metastatic interval after initial diagnosis, treatment with surgery, and endocrine therapy, which for hepatic metastases, were the independent prognostic factors for hepatic metastases breast cancer.…”

Section: 5081 Clinical Characteristics and Survival Analysis Of Breasupporting

confidence: 80%

“…Those patients receiving endocrine therapy had a relatively good overall prognosis, with responders surviving for a median of 23.4 months. This was better than the outcome of previous study (Wyld et al, 2003). Interestingly, we found that endocrine therapy could improve the survival time of luminal subtype patients regardless of endocrine therapy to give patients at initial diagnosis of breast cancer whether or not.…”

Section: 5081 Clinical Characteristics and Survival Analysis Of Breacontrasting

confidence: 56%

Clinical Characteristics and Survival Analysis of Breast Cancer Molecular Subtypes with Hepatic Metastases

Lv²,

Kong³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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(TN, P=0.11). In multivariate analysis, a 2 year-interval from initial diagnosis to hepatic metastasis, treatment with endocrine therapy, and surgery were independent prognostic factors. Endocrine therapy could improve the survival of luminal subtypes (P=0.004) and was a favorable prognostic factor (median survival 23.4 months vs. 13.8 months, respectively, P=0.011). Luminal A group of patients treated with endocrine therapy did significantly better than the Luminal A group of patients treated without endocrine therapy (median survival of 48.9 vs. 13.8 months, P=0.003). Conclusions: Breast cancer subtypes were not associated with survival after hepatic metastases. Endocrine therapy was a significantly favorable treatment for patients with luminal subtype.

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“…The prognosis is poor in this area being the median survival of 1-20 months from the diagnosis of liver metastases [108,109,113,114]. Long survivals seem to be related to a positive endocrine treatment response, performed in the subgroup of patients with positive estrogen receptor pattern, with median survivals around 14 months compared to 4 months in the other cases [114].…”

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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Prognostic factors for patients with hepatic metastases from breast cancer

Cited by 183 publications

References 28 publications

Bone metastases from breast carcinoma: histopathological – radiological correlations and prognostic features

Bone metastases from breast carcinoma: histopathological – radiological correlations and prognostic features

Clinical Characteristics and Survival Analysis of Breast Cancer Molecular Subtypes with Hepatic Metastases

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

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