Liver resections of isolated liver metastasis in breast cancer: results and possible prognostic factors.

Malte Weinrich, Christel Weiß, Jochen Schuld, Bettina M Rau
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引用次数: 34

Abstract

Background. Breast cancer liver metastasis is a hematogenous spread of the primary tumour. It can, however, be the expression of an isolated recurrence. Surgical resection is often possible but controversial. Methods. We report on 29 female patients treated operatively due to isolated breast cancer liver metastasis over a period of six years. Prior to surgery all metastases appeared resectable. Liver metastasis had been diagnosed 55 (median, range 1-177) months after primary surgery. Results. Complete resection of the metastases was performed in 21 cases. The intraoperative staging did not confirm the preoperative radiological findings in 14 cases, which did not generally lead to inoperability. One-year survival rate was 86% in resected patients and 37.5% in nonresected patients. Significant prognostic factors were R0 resection, low T- and N-stages as well as a low-grade histopathology of the primary tumour, lower number of liver metastases, and a longer time interval between primary surgery and the occurrence of liver metastasis. Conclusions. Complete resection of metastases was possible in three-quarters of the patients. Some of the studied factors showed a prognostic value and therefore might influence indication for resection in the future.

Abstract Image

乳腺癌分离性肝转移的肝切除:结果和可能的预后因素。
背景。乳腺癌肝转移是原发肿瘤的血行性扩散。然而,它也可能是孤立复发的表现。手术切除通常是可行的,但存在争议。方法。我们报告了29例女性患者因孤立性乳腺癌肝转移而接受手术治疗的6年。手术前,所有转移灶均可切除。原发性手术后55个月(中位数,范围1-177)被诊断为肝转移。结果。完全切除转移瘤21例。术中分期与术前影像学表现不一致的14例,一般不导致手术不可操作。手术切除患者一年生存率为86%,未手术切除患者一年生存率为37.5%。重要的预后因素为R0切除、低T期和n期以及原发肿瘤的低级别组织病理学、较少的肝转移数量以及原发性手术与肝转移发生的时间间隔较长。结论。四分之三的患者可以完全切除转移灶。研究的一些因素显示出预后价值,因此可能影响未来切除的指征。
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