BACKGROUND/AIMS: Primary focus of the therapy of metastatic breast cancer is currently a systemic therapy. Surgical therapies are of minor importance. Aim of this study was to investigate the relevance of hepatectomy in case of hepatic breast cancer metastases (HBCM) as an important part of multimodal therapy. METHODOLOGY: From January 2002 to December 2011, 30 patients with HBCM underwent hepatectomy. Criteria for hepatectomy were good condition, technical feasibility and control of extrahepatic metastases. For a heterogeneous group of women with HBCM the 3- and 5-year survival rate was determined by Kalpan-Meier survival estimate. RESULTS: The postoperative morbidity was 13.3%, the mortality rate was 3.3%. Minor hepatectomy has been performed in 62.1% and major hepatectomy in 37.9% of the cases. In all patients a R0 resection margin was performed. At a median follow-up interval of 34.1 months, 16 patients were still alive. The 3- and 5-year survival rates after surgically resection of HBCM in our collective were 31.0% and 20.7%. CONCLUSIONS: Hepatectomy is a safe therapy with low morbidity, mortality and improves long-term survival in most patients with limited, resectable HBCM. In our opinion patient selection should not be that strict. The combination of systemic and surgical therapies can improve prognosis and long-term survival of these patients.
BACKGROUND/AIMS: Primary focus of the therapy of metastatic breast cancer is currently a systemic therapy. Surgical therapies are of minor importance. Aim of this study was to investigate the relevance of hepatectomy in case of hepatic breast cancer metastases (HBCM) as an important part of multimodal therapy. METHODOLOGY: From January 2002 to December 2011, 30 patients with HBCM underwent hepatectomy. Criteria for hepatectomy were good condition, technical feasibility and control of extrahepatic metastases. For a heterogeneous group of women with HBCM the 3- and 5-year survival rate was determined by Kalpan-Meier survival estimate. RESULTS: The postoperative morbidity was 13.3%, the mortality rate was 3.3%. Minor hepatectomy has been performed in 62.1% and major hepatectomy in 37.9% of the cases. In all patients a R0 resection margin was performed. At a median follow-up interval of 34.1 months, 16 patients were still alive. The 3- and 5-year survival rates after surgically resection of HBCM in our collective were 31.0% and 20.7%. CONCLUSIONS: Hepatectomy is a safe therapy with low morbidity, mortality and improves long-term survival in most patients with limited, resectable HBCM. In our opinion patient selection should not be that strict. The combination of systemic and surgical therapies can improve prognosis and long-term survival of these patients.
Authors: Eran Sadot; Ser Yee Lee; Constantinos T Sofocleous; Stephen B Solomon; Mithat Gönen; T Peter Kingham; Peter J Allen; Ronald P DeMatteo; William R Jarnagin; Clifford A Hudis; Michael I D'Angelica Journal: Ann Surg Date: 2016-07 Impact factor: 12.969