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Multimodale Therapiekonzepte beim metastasierten Mammakarzinom

Multimodality treatment concepts for metastatic breast cancer

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Zusammenfassung

Während das metastasierte Mammakarzinom bei den meisten Patientinnen als Systemerkrankung verstanden wird, so gibt es doch eine kleinere Subgruppe von Patientinnen, bei denen eine Oligometastasierung im Sinne einer singulären oder auf wenige Lokalisationen beschränkten resektablen Metastasierung gefunden wird. Kann die Stabilität der Erkrankung nach einer Phase der systemischen Behandlung bestätigt werden, so kommen lokoregionär wirksame Verfahren wie die chirurgische Metastasenresektion, die Bestrahlung oder die regionale Chemotherapie in Betracht. Zum gegenwärtigen Zeitpunkt liegen keine prospektiv randomisierten Studien vor, die den Nutzen dieser Strategie hinsichtlich des Gesamtüberlebens belegen. Zahlreiche retrospektive Analysen weisen jedoch auf die Effektivität der lokoregionalen Metastasentherapie bei ausgewählten Patientinnen hin und stellen letztlich eine rasche Krankheitskontrolle sowie auch die Möglichkeit des Langzeitüberlebens nach Metastasenresektion in Aussicht.

Abstract

While metastatic breast cancer is a systemic disease in most patients, there is a smaller subset of patients who suffer from oligometastatic disease defined by single or few resectable metastases. After verification of disease stabilization by systemic therapy, locoregional treatment such as surgery or radiation can be applied. While large prospective trials are missing to support the beneficial effect of this strategy, retrospective analyses are highly suggestive offering rapid disease control and even long-term survival in selected patients.

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Literatur

  1. Adam R, Chiche L, Aloia T et al (2006) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1452 patients and development of a prognostic model. Ann Surg 244:524–535

    Article  PubMed  Google Scholar 

  2. Allgaier HP, Deibert P, Zuber I, Blum HE (1998) Perkutane Behandlung von Lebertumoren durch interstitielle Radio-Frequenz-Thermoablation. Dtsch Med Wochenschr 123:907–911

    Article  PubMed  CAS  Google Scholar 

  3. Atalay G, Biganzoli L, Renard F et al (2003) Clinical outcome of breast cancer patients with liver metastases alone in the anthracycline-taxane era: a retrospective analysis of two prospective, randomized metastatic breast cancer trials. Eur J Cancer 39:2439–2449

    Article  PubMed  CAS  Google Scholar 

  4. Camacho LH, Kurzrock R, Cheung A (2007) Pilot study of regional, hepatic intra-arterial paclitaxel in patients with breast carcinoma metastatic to the liver. Cancer 109:2190–2196

    Article  PubMed  CAS  Google Scholar 

  5. Chia SK, Speers CH, D’yachkiva Y et al (2007) The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer. Cancer 110:973–979

    Article  PubMed  Google Scholar 

  6. Coldwell DM, Kennedy AS, Nutting CW (2007) Use of yttrium-90 microspheres in the treatment of unresectable hepatic metastases from breast cancer. Int J Radiat Oncol Biol Phys 69:800–804

    Article  PubMed  CAS  Google Scholar 

  7. Diamond JR, Finlayson CA, Borges VF (2009) Hepatic complications of breast cancer. Lancet Oncol 10:615–621

    Article  PubMed  Google Scholar 

  8. Elias D, Maisonnette F, Druet-Cabanac M et al (2003) An attempt to clarify indications for hepatectomy for liver metastases from breast cancer. Am J Surg 185:158–164

    Article  PubMed  Google Scholar 

  9. Giordano SH, Buzdar AU, Smith TL et al (2004) Is breast cancer survival improving? Cancer 100:44–52

    Article  PubMed  Google Scholar 

  10. Harris JR (Hrsg) (2000) Diseases of the breast, 2. edn. Lippincott Williams & Wilkins, Philadelphia, p 907

  11. Jardines L, Callans LS, Torosian MH (1993) Recurrent breast cancer: presentation, diagnosis and treatment. Semin Oncol 20:538–547

    PubMed  CAS  Google Scholar 

  12. Kennecke H, Yerushalmi R, Woods R et al (2010) Metastatic behavior of breast cancer subtypes. J Clin Oncol 28:3271–3277

    Article  PubMed  Google Scholar 

  13. Lermite E, Marzano E, Chereau E et al (2009) Surgical resection of liver metastases from breast cancer. Surg Oncol 1–6

  14. Livraghi T, Goldberg SN, Solbiati L et al (2001) Percutaneous radio-frequency ablation of liver metastases from breast cancer: initial experience in 24 patients. Radiology 220:145–149

    PubMed  CAS  Google Scholar 

  15. Mack MG, Straub R, Eichler K et al (2004) Breast cancer metastases in liver: laser-induced interstitial thermotherapy – local tumor control rate and survival data. Radiology 233:400–409

    Article  PubMed  Google Scholar 

  16. Martinez SR, Young SE, Giuliono AE et al (2006) The utility of estrogen receptor, progesterone receptor, and HER-2/neu status to predict survival in patients undergoing hepatic resection for breast cancer metastases. Am J Surg 191:281–283

    Article  PubMed  CAS  Google Scholar 

  17. Pagani O, Senkus E, Wood W et al (2010) International guidelines for management of metastatic breast cancer: Can metastatic breast cancer be cured? J Natl Cancer Inst 102:456–463

    Article  PubMed  Google Scholar 

  18. Pentheroudakis G, Fountzilas G, Bafaloukos D et al (2005) Metastatic breast cancer with liver metastases: a registry analysis of clinicopathologic, management and outcome characteristics of 500 women. Breast Cancer Res Treat 97:237–244

    Article  PubMed  Google Scholar 

  19. Pocard M, Pouillart P, Asselain B et al (2000) Hepatic resection for breast cancer metastases: results and prognostic factors. Eur J Surg Oncol 26:155–159

    Article  PubMed  CAS  Google Scholar 

  20. Popperl G, Helmberger T, Munzing W et al (2005) Selective internal radiation therapy with SIR-Spheres in patients with nonresectable liver tumors. Cancer Biother Radiopharm 20:200–208

    Article  PubMed  Google Scholar 

  21. Raab R, Nussbaum KT, Behrend M, Weimann A (1998) Liver metastases of breast cancer: results of liver resection. Anticancer Res 18:2231–2233

    PubMed  CAS  Google Scholar 

  22. Ryberg M, Nielsen D, Osterlind K et al (2001) Prognostic factors and long-term survival in 585 patients with metastatic breast cancer treated with epirubicin-based chemotherapy. Ann Oncol 12:81–87

    Article  PubMed  CAS  Google Scholar 

  23. Schneebaum S, Walker MJ, Young D et al (1994) The regional treatment of liver metastases from breast cancer. J Surg Oncol 55:26–31

    Article  PubMed  CAS  Google Scholar 

  24. Selzner M, Morse MA, Vredenburgh JJ et al (2000) Liver metastases from breast cancer: long-term survival after curative resection. Surgery 127:383–389

    Article  PubMed  CAS  Google Scholar 

  25. Shibata T, Niinobu T, Ogata N et al (2000) Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma. Cancer 89:276–284

    Article  PubMed  CAS  Google Scholar 

  26. Singletary SE, Walsh G, Vauthey J-N et al (2003) A role for curative surgery in the treatment of selected patients with metastatic breast cancer. Oncologist 8:241–251

    Article  PubMed  Google Scholar 

  27. Tait CR, Waterworth A, Loncaster J et al (2005) The oligometastatic state in breast cancer: hypothesis or reality. Breast 14:87–93

    Article  PubMed  Google Scholar 

  28. Tomiak E, Piccart M, Mignolet et al (1996) Characterization of complete responders to combination chemotherapy for advanced breast cancer: a retrospective EORTC Breast Group study. Eur J Cancer 32A:1876–1887

    Article  PubMed  CAS  Google Scholar 

  29. Vogl TJ, Muller PK, Mack MG et al (1999) Liver metastases; interventional therapeutic techniques and results, state of the art. Eur Radiol 9:675–684

    Article  PubMed  CAS  Google Scholar 

  30. Wyld L, Gutteridge E, Pinder SE et al (2003) Prognostic factors for patients with hepatic metastases from breast cancer. Br J Cancer 89:284–290

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik III, Comprehensive Cancer Center LMU, Klinikum der Universität München, Marchioninistraße 15, 81377, München, Deutschland

    V. Heinemann & H.-J. Stemmler

  2. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum Großhadern der Universität München, München, Deutschland

    S. Kahlert

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  1. V. Heinemann
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  2. S. Kahlert
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  3. H.-J. Stemmler
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Correspondence to V. Heinemann.

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Heinemann, V., Kahlert, S. & Stemmler, HJ. Multimodale Therapiekonzepte beim metastasierten Mammakarzinom. Internist 51, 1358–1365 (2010). https://doi.org/10.1007/s00108-010-2676-4

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