Literature DB >> 21418133

Surgical management of breast cancer liver metastases.

Maria A Cassera1, Chet W Hammill, Michael B Ujiki, Ronald F Wolf, Lee L Swanström, Paul D Hansen.   

Abstract

INTRODUCTION: Selected patients with isolated breast cancer liver metastases (BCLM) may benefit from surgical management; however, indications remain unclear and the risks may outweigh the benefits in patients with a generally poor prognosis.
METHODS: Between 1998 and 2006, 17 patients diagnosed with BCLM were considered for surgical management (<4 tumours, tumour <4 cm in diameter and no/stable extrahepatic metastases). Peri-operative and outcomes data were analysed and compared.
RESULTS: Eight patients were found to have extensive or untreatable disease on staging laparoscopy and intra-operative ultrasound (SL/IOUS). The remaining nine patients underwent surgical management [seven laparoscopic radiofrequency ablations (RFA) and two hepatic resections]. Median length of follow-up for patients treated surgically was 40.0 months, median disease-free survival (DFS) was 32.2 months and median time to disease progression was 17.7 months. Of the eight patients not amenable to surgery, median length of follow-up was 21.8 months.
CONCLUSION: SL/IOUS prevented unnecessary laparotomy in half of the patients taken to the operating room for surgical treatment of BCLM. In patients with BCLM, SL/IOUS should be considered standard of care before surgical intervention. The small number of patients and short follow-up may be inadequate to determine the true value of surgical management in this group of patients with BCLM.
© 2011 International Hepato-Pancreato-Biliary Association.

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Year:  2011        PMID: 21418133      PMCID: PMC3081628          DOI: 10.1111/j.1477-2574.2010.00282.x

Source DB:  PubMed          Journal:  HPB (Oxford)        ISSN: 1365-182X            Impact factor:   3.647


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