The role of liver-directed surgery in patients with hepatic metastasis from primary breast cancer: a multi-institutional analysis. Issue 8 (August 2016)

• Record Type: Journal Article
• Authors: Margonis, Georgios A.; Buettner, Stefan; Sasaki, Kazunari; Kim, Yuhree; Ratti, Francesca; Russolillo, Nadia; Ferrero, Alessandro; Berger, Nickolas; Gamblin, T. Clark; Poultsides, George; Tran, Thuy; Postlewait, Lauren M.; Maithel, Shishir; Michaels, Alex D.; Bauer, Todd W.; Marques, Hugo; Barroso, Eduardo; Aldrighetti, Luca; Pawlik, Timothy M.
• Is Part Of: HPB. Volume 18:Issue 8(2016)
• Page Start: 700
• Page End: 705
• Publication Date: 2016-08
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2016.05.014
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Data on surgical management of breast liver metastasis are limited. We sought to determine the safety and long-term outcome of patients undergoing hepatic resection of breast cancer liver metastases (BCLM). Methods: Using a multi-institutional, international database, 131 patients who underwent surgery for BCLM between 1980 and 2014 were identified. Clinicopathologic and outcome data were collected and analyzed. Results: Median tumor size of the primary breast cancer was 2.5 cm (IQR: 2.0–3.2); 58 (59.8%) patients had primary tumor nodal metastasis. The median time from diagnosis of breast cancer to metastasectomy was 34 months (IQR: 16.8–61.3). The mean size of the largest liver lesion was 3.0 cm (2.0–5.0); half of patients (52.0%) had a solitary metastasis. An R0 resection was achieved in most cases (90.8%). Postoperative morbidity and mortality were 22.8% and 0%, respectively. Median and 3-year overall-survival was 53.4 months and 75.2%, respectively. On multivariable analysis, positive surgical margin (HR 3.57, 95% CI 1.40–9.16; p = 0.008) and diameter of the BCLM (HR 1.03, 95% CI 1.01–1.06; p = 0.002) remained associated with worse OS. Discussion: In selected patients, resection of breast cancer liver metastases can be done safely and a subset of patients may derive a relatively long survival, especially from a margin negative resection.