Eran Sadot1, Ser Yee Lee1,2, Constantinos T Sofocleous3, Stephen B Solomon3, Mithat Gönen4, T Peter Kingham1, Peter J Allen1, Ronald P DeMatteo1, William R Jarnagin1, Clifford A Hudis5, Michael I D'Angelica1. 1. Department of Surgery, Memorial Sloan Kettering Cancer Center 1275 Avenue, New York, NY10065, United States of America. 2. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore. 3. Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center 1275 York Avenue, New York, NY10065, United States of America. 4. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY10065, United States of America. 5. Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center 1275 York Avenue, New York, NY10065, United States of America.
Abstract
OBJECTIVE: To evaluate the efficacy of surgical treatment for patients with isolated breast cancer liver metastases (BCLM). BACKGROUND: Single-arm retrospective studies have shown promising results associated with surgery for isolated BCLM; however, this treatment remains controversial and its role is not well-defined. METHODS: A review of 2150 patients with BCLM who underwent treatment in a single institution was conducted, and 167 (8%) patients with isolated BCLM were identified. A case-control study was conducted to compare outcomes in patients with isolated BCLM who underwent surgery and/or ablation to patients who underwent conventional medical therapy. RESULTS: A total of 167 patients were included (surgery/ablation: 69; medical: 98), with a median follow-up for survivors of 73 months. Patients in the surgical cohort more frequently had estrogen receptor-positive tumors and received adjuvant chemotherapy and radiotherapy for their primary breast tumor. The hepatic tumor burden was less and the interval from breast cancer diagnosis to BCLM was significantly longer (53 vs 30 months) in the surgical cohort. Patients undergoing surgical treatment had a median recurrence-free interval of 28.5 months (95% confidence interval (CI): 19-38) with 10 patients (15%) recurrence free after 5 years. There was no significant difference in overall survival (OS) between the surgical and medical cohorts (median OS: 50 vs 45 months; 5-year OS: 38% vs 39%). CONCLUSIONS: Hepatic resection and/or ablation was not associated with a survival advantage. However, significant recurrence-free intervals can be accomplished with surgical treatment. Surgical intervention might be considered in highly selected patients with the goal of providing time off of systemic chemotherapy.
OBJECTIVE: To evaluate the efficacy of surgical treatment for patients with isolated breast cancer liver metastases (BCLM). BACKGROUND: Single-arm retrospective studies have shown promising results associated with surgery for isolated BCLM; however, this treatment remains controversial and its role is not well-defined. METHODS: A review of 2150 patients with BCLM who underwent treatment in a single institution was conducted, and 167 (8%) patients with isolated BCLM were identified. A case-control study was conducted to compare outcomes in patients with isolated BCLM who underwent surgery and/or ablation to patients who underwent conventional medical therapy. RESULTS: A total of 167 patients were included (surgery/ablation: 69; medical: 98), with a median follow-up for survivors of 73 months. Patients in the surgical cohort more frequently had estrogen receptor-positive tumors and received adjuvant chemotherapy and radiotherapy for their primary breast tumor. The hepatic tumor burden was less and the interval from breast cancer diagnosis to BCLM was significantly longer (53 vs 30 months) in the surgical cohort. Patients undergoing surgical treatment had a median recurrence-free interval of 28.5 months (95% confidence interval (CI): 19-38) with 10 patients (15%) recurrence free after 5 years. There was no significant difference in overall survival (OS) between the surgical and medical cohorts (median OS: 50 vs 45 months; 5-year OS: 38% vs 39%). CONCLUSIONS: Hepatic resection and/or ablation was not associated with a survival advantage. However, significant recurrence-free intervals can be accomplished with surgical treatment. Surgical intervention might be considered in highly selected patients with the goal of providing time off of systemic chemotherapy.
Authors: Michael Hwang; Thejus T Jayakrishnan; Danielle E Green; Ben George; James P Thomas; Ryan T Groeschl; Beth Erickson; Sam G Pappas; T Clark Gamblin; Kiran K Turaga Journal: Eur J Cancer Date: 2014-04-21 Impact factor: 9.162
Authors: James S Tomlinson; William R Jarnagin; Ronald P DeMatteo; Yuman Fong; Peter Kornprat; Mithat Gonen; Nancy Kemeny; Murray F Brennan; Leslie H Blumgart; Michael D'Angelica Journal: J Clin Oncol Date: 2007-10-10 Impact factor: 44.544
Authors: Dominique Elias; Franck Maisonnette; Michel Druet-Cabanac; Jean Francois Ouellet; Jean Marc Guinebretiere; Marc Spielmann; Suzette Delaloge Journal: Am J Surg Date: 2003-02 Impact factor: 2.565
Authors: C T Sofocleous; R G Nascimento; M Gonen; M Theodoulou; A M Covey; L A Brody; S M Solomon; R Thornton; Y Fong; G I Getrajdman; K T Brown Journal: AJR Am J Roentgenol Date: 2007-10 Impact factor: 3.959
Authors: Andy J Minn; Gaorav P Gupta; David Padua; Paula Bos; Don X Nguyen; Dimitry Nuyten; Bas Kreike; Yi Zhang; Yixin Wang; Hemant Ishwaran; John A Foekens; Marc van de Vijver; Joan Massagué Journal: Proc Natl Acad Sci U S A Date: 2007-04-09 Impact factor: 11.205
Authors: Laurien D C Hoefnagel; Marc J van de Vijver; Henk-Jan van Slooten; Pieter Wesseling; Jelle Wesseling; Pieter J Westenend; Joost Bart; Cornelis A Seldenrijk; Iris D Nagtegaal; Joost Oudejans; Paul van der Valk; Petra van der Groep; Elisabeth G E de Vries; Elsken van der Wall; Paul J van Diest Journal: Breast Cancer Res Date: 2010-09-23 Impact factor: 6.466
Authors: Georgios A Margonis; Stefan Buettner; Kazunari Sasaki; Yuhree Kim; Francesca Ratti; Nadia Russolillo; Alessandro Ferrero; Nickolas Berger; T Clark Gamblin; George Poultsides; Thuy Tran; Lauren M Postlewait; Shishir Maithel; Alex D Michaels; Todd W Bauer; Hugo Marques; Eduardo Barroso; Luca Aldrighetti; Timothy M Pawlik Journal: HPB (Oxford) Date: 2016-06-29 Impact factor: 3.647
Authors: Dayna P Y Sim; Brian K P Goh; Ser-Yee Lee; Chung-Yip Chan; Iain B H Tan; Peng-Chung Cheow; Premaraj Jeyaraj; Pierce K H Chow; London L P J Ooi; Alexander Y F Chung Journal: World J Surg Date: 2018-04 Impact factor: 3.352
Authors: Yun Shin Chun; Takashi Mizuno; Jordan M Cloyd; Min Jin Ha; Kiyohiko Omichi; Ching-Wei D Tzeng; Thomas A Aloia; Naoto T Ueno; Henry M Kuerer; Carlos H Barcenas; Jean-Nicolas Vauthey Journal: Eur J Surg Oncol Date: 2020-03-28 Impact factor: 4.424
Authors: Sadia Tasleem; Jarlath C Bolger; Michael E Kelly; Michael R Boland; Dermot Bowden; Karl J Sweeney; Carmel Malone Journal: Ir J Med Sci Date: 2018-02-01 Impact factor: 1.568