Aldrick Ruiz1,2, Dennis A Wicherts3, Mylène Sebagh1, Sylvie Giacchetti1,4, Carlos Castro-Benitez1,5, Richard van Hillegersberg2, Bernard Paule1,6, Denis Castaing1,7, Jean-François Morère6,8, René Adam9,10. 1. Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France. 2. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 3. Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. 4. Département de Cancérologie, APHP, Hopital Saint Louis, Paris, France. 5. Department of Surgery, Hospital Mexico, San José, Costa Rica. 6. Département de Cancérologie, AP-HP Hôpital Paul Brousse, Villejuif, France. 7. Inserm, Université Paris-Sud, UMR-S 785, Villejuif, France. 8. Université Paris-Sud, UMR-S 785, 94804, Villejuif, France. 9. Centre Hépato-Biliaire, AP-HP Hôpital Paul Brousse, Villejuif, France. rene.adam@pbr.aphp.fr. 10. Université Paris-Sud, UMR-S 785, 94804, Villejuif, France. rene.adam@pbr.aphp.fr.
Abstract
BACKGROUND: Breast cancer liver metastases (BCLM) are considered the most lethal compared with other sites of metastases in patients with breast cancer. This study aimed to evaluate the outcome after hepatectomy for BCLM within current multidisciplinary treatment and to develop a clinically useful nomogram to predict survival. METHODS: Between January 1985 and December 2012, 139 consecutive female patients underwent liver resection for BCLM at the authors' institution. Clinicopathologic data were collected and analyzed for survival outcome with determination of prognostic factors. A nomogram to predict survival was developed based on a multivariate Cox model. The predictive performance of the model was assessed according to the C-statistic and calibration plots. RESULTS: After a median follow-up period of 55 months, the overall 3- and 5-year survival rates after hepatectomy were respectively 58 and 47 %. The median overall survival period was 56 months, and the median disease-free survival period after surgical resection was 33 months. A single hepatic metastasis, no triple negative tumors, no microscopic vascular invasion, and perioperative hormonal or targeted therapy were related to improved overall survival. The model achieved good discrimination and calibration, with a C-statistic of 0.80. CONCLUSIONS: Liver resection for selected patients with breast cancer metastases can provide significant survival benefit. It should be part of a multidisciplinary treatment program in experienced liver surgery centers. The authors' nomogram facilitates personalized assessment of prognosis for these patients.
BACKGROUND:Breast cancer liver metastases (BCLM) are considered the most lethal compared with other sites of metastases in patients with breast cancer. This study aimed to evaluate the outcome after hepatectomy for BCLM within current multidisciplinary treatment and to develop a clinically useful nomogram to predict survival. METHODS: Between January 1985 and December 2012, 139 consecutive female patients underwent liver resection for BCLM at the authors' institution. Clinicopathologic data were collected and analyzed for survival outcome with determination of prognostic factors. A nomogram to predict survival was developed based on a multivariate Cox model. The predictive performance of the model was assessed according to the C-statistic and calibration plots. RESULTS: After a median follow-up period of 55 months, the overall 3- and 5-year survival rates after hepatectomy were respectively 58 and 47 %. The median overall survival period was 56 months, and the median disease-free survival period after surgical resection was 33 months. A single hepatic metastasis, no triple negative tumors, no microscopic vascular invasion, and perioperative hormonal or targeted therapy were related to improved overall survival. The model achieved good discrimination and calibration, with a C-statistic of 0.80. CONCLUSIONS: Liver resection for selected patients with breast cancer metastases can provide significant survival benefit. It should be part of a multidisciplinary treatment program in experienced liver surgery centers. The authors' nomogram facilitates personalized assessment of prognosis for these patients.
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: Zoltán Mátrai; Péter Kelemen; Csaba Kósa; Róbert Maráz; Attila Paszt; Gábor Pavlovics; Ákos Sávolt; Zsolt Simonka; Dezső Tóth; Miklós Kásler; Andrey Kaprin; Petr Krivorotko; Ferenc Vicko; Piotr Pluta; Agnieszka Kolacinska-Wow; Dawid Murawa; Jerzy Jankau; Slawomir Ciesla; Daniel Dyttert; Martin Sabol; Andrii Zhygulin; Artur Avetisyan; Alexander Bessonov; György Lázár Journal: Pathol Oncol Res Date: 2022-06-15 Impact factor: 2.874