[Surgical therapy of liver metastases in breast carcinoma]

The literature contains little information on the surgical treatment of metastases from carcinoma of the breast. Advanced stages of mammary cancer with generalised metastatic spread are considered to be the therapeutic domain of systemic chemotherapy. Patients with isolated liver metastases may, under certain circumstances, be considered candidates for partial resection of the liver. Another therapeutic option in this group of patients is intraarterial chemotherapy via a port catheter system implanted in the hepatic artery. A number of institutions employ a combination of both treatment modalities. Overall 5-year survival rates are low for both the regional and the systemic form of treatment. A carefully selected group of patients may be expected to benefit from partial resection of the liver, intraarterial chemotherapy or a combination of the two by having their survival time prolonged--provided that due consideration is given to all contraindications, and there are no extrahepatic manifestations. Wherever possible, resections should be carried out in curative intent. However, palliative resection may be justified in individual cases where alleviation of symptoms and an improvement in the patient's quality of life is to be expected. The present paper discusses the results achieved in 21 women who underwent liver resection at the surgical department of the University of Erlangen between 1980 and 1997, and compares these results with those reported in the literature. The average age of the patients was 54 years, and 9 had a solitary metastasis. As was to be expected, the R classification had a decisive influence on survival. The 2-year survival rate was 60% for R0 resections as compared with 16.7% for R1 or R2 resections.