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Liver resection in selected patients with metastatic breast cancer: a single-centre analysis and review of literature

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Abstract

Purpose

Despite the development of modern chemotherapeutics and target-specific drugs as well as improved surgical techniques, prognosis of metastatic breast cancer remains poor. Only a small number of selected patients will be eligible for liver resection and/or alternative metastatic ablation. Data on prognostic factors for patients with surgically resectable liver metastases of breast cancer are scarce at present.

Methods

From 1997 to 2010, 50 patients with hepatic metastases of breast cancer have undergone laparotomy with the intention to undergo a curative liver resection at our institution. Data from these patients were collected in a prospectively maintained standardized liver resection data base.

Results

Liver resection was performed in 34 patients. Resection margins were clear in 21 cases (R0). Nine patients lived for more than 60 months after liver resection. The observed 5-year survival rate was 21 % for all 50 patients, 28 % for resected patients and 38 % after R0-resection. On univariate analysis, survival rates of the resected patients were statistically significantly influenced by R-classification, age, extrahepatic tumour at the time of liver resection, size of metastases and HER2 expression of liver metastases. Multivariate analysis revealed absence of HER2 expression, presence of extrahepatic tumour and patient’s age ≥50 years as independent factors of poor prognosis.

Conclusions

Breast cancer patients younger than 50 years with technically resectable hepatic metastases, minimal extrahepatic tumour and positive HER2 expression appear to be suitable candidates for liver resection with curative intent. An aggressive multi-disciplinary management of those patients including surgical treatment may improve long-term survival.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of General, Visceral und Vascular Surgery, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany

    Y. Dittmar, A. Altendorf-Hofmann, S. Schüle, M. Ardelt & U. Settmacher

  2. Institute of Pathology, Jena University Hospital, Jena, Germany

    O. Dirsch

  3. Department of Gynaecology and Obstetrics, Jena University Hospital, Jena, Germany

    I. B. Runnebaum

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  1. Y. Dittmar
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  2. A. Altendorf-Hofmann
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  3. S. Schüle
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  4. M. Ardelt
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  5. O. Dirsch
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  6. I. B. Runnebaum
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  7. U. Settmacher
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Correspondence to Y. Dittmar.

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Dittmar, Y., Altendorf-Hofmann, A., Schüle, S. et al. Liver resection in selected patients with metastatic breast cancer: a single-centre analysis and review of literature. J Cancer Res Clin Oncol 139, 1317–1325 (2013). https://doi.org/10.1007/s00432-013-1440-2

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  • DOI: https://doi.org/10.1007/s00432-013-1440-2

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