Surgical treatment of hepatic metastases from breast cancer

Abstract

We have performed a retrospective study to evaluate whether surgical treatment is beneficial in patients with hepatic metastases from breast cancer. Between September 1985 and September 1998, 25 patients with hepatic metastases (14 solitary and 11 multiple), eight of whom had extrahepatic metastases, underwent hepatectomy. All of the detectable liver metastasis were resected in all of the cases. There were no severe postoperative complications. All but one of the patients received adjunctive polychemotherapy after the hepatectomy. After the hepatectomy, recurrent tumors were detected in 18 of the patients, being located in the liver in 12 (67%) of them. Overall, however, hepatectomy ensured that the liver was clinically recurrence-free for a median of 24 months (range 2-132 months). Eleven patients died of recurrent tumors, two died of other causes and the remaining 12 are currently alive. The 2- and 5-year cumulative survival rates after hepatectomy were 71% and 27%, respectively, and the median survival duration was 34.3 +/- 3.2 months, much better than the period of 8.5 months for another series of patients treated with standard or non-surgical therapies at our institution. The number and the size of hepatic metastases, the interval between treatment of the primary lesion and hepatectomy, and the existence of extrahepatic metastasis were not adverse prognostic factors. In conclusion, our data, although limited and highly selective, suggest that surgical treatment of hepatic metastases from breast cancer may prolong survival in certain subgroups of patients to a greater extent than standard or non-surgical therapies.

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

“…Presence of EHD had a negative effect in the studies by Sakamoto and Thelen [27,35], but was not significant in other studies [20,21,31].…”

“…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).…”

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

“…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. 6 Although there appears to be a survival benefit for those undergoing hepatectomy, the numbers included in the studies tend to be small, ranging from 15-54; due to the highly selective nature of the treatment group, a control group is never included.…”

“…A small group of patients with metastasis confined to the liver (5-12%) 1 appear 2 to have an improved prognosis following hepatic resection and 3-year survival rates of 35-71% have been reported although disease-free survival rates are considerably lower. [3][4][5][6] It has been suggested that hepatic resection improves survival by means of reducing the tumour burden of the patient, thus allowing subsequent hormonal or chemotherapy to be more effective. 7,8 Radiofrequency ablation (RFA) is a relatively simple percutaneous technique that has been demonstrated to be an effective cytoreductive strategy for a variety of metastatic liver malignancies, with few side effects and little disruption of the patients life.…”

The Biology of Metastasis to a Sanctuary Site

“…14), lung carcinoma (15,16), and breast carcinoma (17 -24). A model of metastasis to the choroid of the eye was reported in which tumor cells also invaded the brain (25).…”