Skip to main content

Advertisement

SpringerLink
Log in

Liver resection for breast cancer metastasis: Does it improve survival?

  • Original Articles
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To assess the outcome and prognostic factors of liver surgery for breast cancer metastasis.

Methods

We retrospectively examined 16 patients who underwent partial liver resection for breast cancer liver metastasis (BCLM). All patients had been treated with chemotherapy or hormonotherapy, or both, before referral for surgery. We confirmed by preoperative radiological examinations that metastasis was confined to the liver. The survival curve was estimated using the Kaplan-Meier method. Univariate and multivariate analysis were conducted to evaluate the role of the known factors of breast cancer survival.

Results

The median age of the patients was 54 years (range 38–68) and the median disease-free interval between the diagnoses of breast cancer and liver metastasis was 54 months (range 7–120). Nine major and 7 minor hepatectomies were performed. There was no postoperative death. The overall 1-, 3-, and 5-year survival rates were 94%, 61%, and 33%, respectively. The median survival rate was 42 months. Univariate analysis revealed that hormone receptor status, number of metastases, a major hepatectomy, and a younger age were associated with a poorer prognosis. The survival rate was not influenced by the disease-free interval, grade or stage of breast cancer, or intraoperative blood transfusions. The number of liver metastases was identified as a significant independent factor of survival according to the Cox proportional hazard model (P = 0.04).

Conclusions

Liver resection, when done in combination with adjuvant therapy, can improve the prognosis of selected patients with BCLM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Brun B, Benchalal M, Lebas C, Piedbois P, Lin M, Lebourgeois JP. Response to second-line chemotherapy in patients with metastatic breast carcinoma previously responsive to first-line treatment: prognostic factors. Cancer 1997;79(11):2137–2146.

    Article  PubMed  CAS  Google Scholar 

  2. Elias D, Lasser P, Spielmann M, May-Levin F, el Malt O, Thomas H, et al. Surgical and chemotherapeutic treatment of hepatic metastases from carcinoma of the breast. Surg Gynecol Obstet 1991;172(6):461–464.

    PubMed  CAS  Google Scholar 

  3. Schneebaum S, Walker MJ, Young D, Farrar WB, Minton JP. The regional treatment of liver metastases from breast cancer. J Surg Oncol 1994;55(1):26–31; discussion 32.

    Article  PubMed  CAS  Google Scholar 

  4. Maksan SM, Lehnert T, Bastert G, Herfarth C. Curative liver resection for metastatic breast cancer. Eur J Surg Oncol 2000;26(3):209–212.

    Article  PubMed  CAS  Google Scholar 

  5. Pocard M, Pouillart P, Asselain B, Salmon R. Hepatic resection in metastatic breast cancer: results and prognostic factors. Eur J Surg Oncol 2000;26(2):155–159.

    Article  PubMed  CAS  Google Scholar 

  6. Elias D, Maisonnette F, Druet-Cabanac M, Ouellet JF, Guinebretiere JM, Spielmann M, et al. An attempt to clarify indications for hepatectomy for liver metastases from breast cancer. Am J Surg 2003;185(2):158–164.

    Article  PubMed  Google Scholar 

  7. Sakamoto Y, Yamamoto J, Yoshimoto M, Kasumi F, Kosuge T, Kokudo N, et al. Hepatic resection for metastatic breast cancer: prognostic analysis of 34 patients. World J Surg 2005;29(4):524–527.

    Article  PubMed  Google Scholar 

  8. Selzner M, Morse MA, Vredenburgh JJ, Meyers WC, Clavien PA. Liver metastases from breast cancer: long-term survival after curative resection. Surgery 2000;127(4):383–389.

    Article  PubMed  CAS  Google Scholar 

  9. World Health Organization. World Health Organization handbook for reporting results of cancer treatment. Geneva: World Health Organization; 1979.

    Google Scholar 

  10. Jaeck D, Bachellier P, Guiguet M, Boudjema K, Vaillant JC, Balladur P, et al. Long-term survival following resection of colorectal hepatic metastases. Association Francaise de Chirurgie. Br J Surg 1997;84(7):977–980.

    Article  PubMed  CAS  Google Scholar 

  11. Nakamura S, Suzuki S, Baba S. Resection of liver metastases of colorectal carcinoma. World J Surg 1997;21(7):741–747.

    Article  PubMed  CAS  Google Scholar 

  12. Harmon KE, Ryan JA Jr, Biehl TR, Lee FT. Benefits and safety of hepatic resection for colorectal metastases. Am J Surg 1999;177(5):402–404.

    Article  PubMed  CAS  Google Scholar 

  13. Clark GM, Sledge GW Jr, Osborne CK, McGuire WL. Survival from first recurrence: relative importance of prognostic factors in 1015 breast cancer patients. J Clin Oncol 1987;5(1):55–61.

    PubMed  CAS  Google Scholar 

  14. Insa A, Lluch A, Prosper F, Marugan I, Martinez-Agullo A, Garcia-Conde J. Prognostic factors predicting survival from first recurrence in patients with metastatic breast cancer: analysis of 439 patients. Breast Cancer Res Treat 1999;56(1):67–78.

    Article  PubMed  CAS  Google Scholar 

  15. Koenders PG, Beex LV, Kloppenborg PW, Smals AG, Benraad TJ. Human breast cancer: survival from first metastasis. Breast Cancer Study Group. Breast Cancer Res Treat 1992;21(3):173–180.

    Article  PubMed  CAS  Google Scholar 

  16. Pouillart P, Jouvet M, Palangie T, Garcia-Giralt E, Bretaudeau B, Dorval T, et al. Hepatic metastases of breast cancer. Analysis of the parameters which influence the response to chemotherapy. Ann Gastroenterol Hepatol (Paris) 1985;21(2):87–90.

    CAS  Google Scholar 

  17. Wyld L, Gutteridge E, Pinder SE, James JJ, Chan SY, Cheung KL, et al. Prognostic factors for patients with hepatic metastases from breast cancer. Br J Cancer 2003;89(2):284–290.

    Article  PubMed  CAS  Google Scholar 

  18. O’Reilly SM, Richards MA, Rubens RD. Liver metastases from breast cancer: the relationship between clinical, biochemical and pathological features and survival. Eur J Cancer 1990;26(5):574–577.

    Article  PubMed  CAS  Google Scholar 

  19. Rahman ZU, Frye DK, Smith TL, Asmar L, Theriault RL, Buzdar AU, et al. Results and long term follow-up for 1581 patients with metastatic breast carcinoma treated with standard dose doxorubicin-containing chemotherapy: a reference. Cancer 1999;85(1):104–111.

    Article  PubMed  CAS  Google Scholar 

  20. Lee YT. Breast carcinoma: pattern of recurrence and metastasis after mastectomy. Am J Clin Oncol 1984;7(5):443–449.

    Article  PubMed  CAS  Google Scholar 

  21. Khalil HI, Patterson SA, Panicek DM. Hepatic lesions deemed too small to characterize at CT: prevalence and importance in women with breast cancer. Radiology 2005;235(3):872–878.

    Article  PubMed  Google Scholar 

  22. Lind P, Igerc I, Beyer T, Reinprecht P, Hausegger K. Advantages and limitations of FDG PET in the follow-up of breast cancer. Eur J Nucl Med Mol Imaging 2004;31suppl 1:S125–S134.

    PubMed  Google Scholar 

  23. Schirrmeister H, Kuhn T, Guhlmann A, Santjohanser C, Horster T, Nussle K, et al. Fluorine-18 2-deoxy-2-fluoro-D-glucose PET in the preoperative staging of breast cancer: comparison with the standard staging procedures. Eur J Nucl Med 2001;28:351–358.

    Article  PubMed  CAS  Google Scholar 

  24. Yoshimoto M, Tada T, Saito M, Takahashi K, Uchida Y, Kasumi F. Surgical treatment of hepatic metastases from breast cancer. Breast Cancer Res Treat 2000;59(2):177–184.

    Article  PubMed  CAS  Google Scholar 

  25. Vlastos G, Smith DL, Singletary SE, Mirza NQ, Tuttle TM, Popat RJ, et al. Long-term survival after an aggressive surgical approach in patients with breast cancer hepatic metastases. Ann Surg Oncol 2004;11(9):869–874.

    Article  PubMed  Google Scholar 

  26. Lee CG, McCormick B, Mazumdar M, Vetto J, Borgen PI. Infiltrating breast carcinoma in patients age 30 years and younger: long term outcome for life, relapse, and second primary tumors. Int J Radiat Oncol Biol Phys 1992;23(5):969–975.

    PubMed  CAS  Google Scholar 

  27. De Brux J. Histopathologie du sein. Paris: Masson; 1979.

    Google Scholar 

  28. Porter GJ, Evans AJ, Pinder SE, James JJ, Cornford EC, Burrell HC, et al. Patterns of metastatic breast carcinoma: influence of tumour histological grade. Clin Radiol 2004;59(12):1094–1098.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Digestive Surgery, Rouen University Hospital, Charles Nicolle 1, rue de Germont, 76031, Rouen, France

    Jean Lubrano & Michel Scotté

  2. Department of Gynecology and Obstetrics, Rouen University Hospital, Charles Nicolle 1, rue de Germont, 76031, Rouen, France

    Horace Roman, Sophie Tarrab, Benoit Resch & Loïc Marpeau

  3. Department of INSERM U 519, Rouen University Hospital, Charles Nicolle 1, rue de Germont, 76031, Rouen, France

    Michel Scotté

Authors
  1. Jean Lubrano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Horace Roman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sophie Tarrab
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Benoit Resch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Loïc Marpeau
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michel Scotté
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lubrano, J., Roman, H., Tarrab, S. et al. Liver resection for breast cancer metastasis: Does it improve survival?. Surg Today 38, 293–299 (2008). https://doi.org/10.1007/s00595-007-3617-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-007-3617-2

Key words

Search

Navigation