Surgery for Liver Metastases from Breast Cancer

Abstract

Liver surgery for BCLM can be performed with low mortality, acceptable morbidity and promising survival benefit in carefully selected patients.

The role of liver-directed surgery in patients with hepatic metastasis from primary breast cancer: a multi-institutional analysis

“…6 For these patients, a recent meta-analysis reported a 5-year survival of 39% following curative intent liver resection of BCLM. 7 Furthermore, median perioperative morbidity and mortality after liver resection of BCLM was reported to be 13% and 0.3%, respectively. 7 While the FDA has approved over 25 oncology drugs to treat breast cancer, there are disparate response rates with systemic chemotherapy.…”

“…7 Furthermore, median perioperative morbidity and mortality after liver resection of BCLM was reported to be 13% and 0.3%, respectively. 7 While the FDA has approved over 25 oncology drugs to treat breast cancer, there are disparate response rates with systemic chemotherapy. 8 Specifically, while up to 90% of primary tumors may respond to chemotherapy, systemic therapy is less effective for metastatic lesions, as only about 50% of metastatic lesions will respond.…”

“…12 As a result, most data on surgical management of BCLM have come from small, retrospective studies. 7,13,14 In fact, only a handful of single-institution studies had sufficient sample size to report on clinicopathologic prognostic factors in multivariable analysis. 7,[15][16][17][18] As such, data on selection of patients with BCLM who might potentially benefit from a liver resection are lacking.…”

“…7,13,14 In fact, only a handful of single-institution studies had sufficient sample size to report on clinicopathologic prognostic factors in multivariable analysis. 7,[15][16][17][18] As such, data on selection of patients with BCLM who might potentially benefit from a liver resection are lacking. The aim of the current study was to define the long-term outcomes of a select group of patients who underwent resection of BCLM, as well as identify which factors were associated with prognosis using a large international, multicenter collaborative database.…”

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

“…Several studies have shown that elevation of serum tumour markers occurs significantly in advance of diagnosis of BC recurrence using radiodiagnostic methods (15,16). This is why some authors recommend the use of a combination of several tumour markers, especially CEA, CA 15-3 and cytokeratins, to increase the sensitivity of relapse detection, namely every 3 months after surgery during the first 5 years and every 6 months thereafter (17,18). Guidelines of the European Group on Tumour Markers and the National Academy of Clinical Biochemistry recommend the use of tumour markers for the diagnosis of early disease recurrences (19)(20)(21)(22).…”