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Aggressive treatment for hepatic metastases from breast cancer: results from a single center
F Polistina1, G Costantin, A Febbraro
1Department of General and Oncologic Surgery, Monselice Hospital, Via G. Marconi, 35043, Monselice, Italy. francescopolistina@hotmail.it
Background:
Breast cancer (BC) is the most common cancer among women worldwide. It has been estimated that approximately 12-20 % of patients will develop liver metastases from breast cancer (BCLM) and that in approximately 5 % of cases the liver is the only metastatic site. Patients with isolated BCLM have the poorest prognosis with a median survival ranging from 19 to 26 months.
Methods:
A total of 26 women with isolated BCLM and without any sign of disease progression after a cycle of chemotherapy were retrospectively reviewed. Women were treated with hepatic resection (HR) for unilobar disease or surgical "open" RFA for bilobar disease. Data were collected on either original BC or BCLM and from patients follow-up.
Results:
Overall survival from BC diagnosis was 47.69 ± 22.25 months (range 33-84, median 45.5 months); it was 52.25 ± 14.57 months (range 33-84, median 48.5 months) for the HR patients and 43.79 ± 27.14 months (range 9-101, median 39 months) for the RFA patients. Overall survival from BCLM treatment was 21.12 ± 12.78 months (range 9-64, median 15.5 months); in detail it was 29.42 ± 14.53 months (range 12-64, median 29.5 months) for the resected patients and 14 ± 4.45 months (range 9-24, median 13.5 months) for patients treated by RFA with a strongly significant survival difference for operated patients (p = 0.001). Overall disease-free survival from BCLM was 15.96 ± 13.16 months (range 3-64, median 12 months), disease-free survival for resected patients was 23.22 ± 16.2 months (range 8-64, median 18.5 months), and for patients treated by RFA was 9.64 ± 4.22 months (range 3-18, median 9 months; Fig. 1). Overall 1, 2, and 5 years (actuarial) survival was respectively 80.7, 57, and 31 %. Given in details for the two groups, they were respectively 100, 66.6 and 34 % (actuarial) for the resected group patients and 64.2, 21.4, and 11.5 % (actuarial) for the RFA patients. Fig. 1 Kaplan-Meier analysis of survival after BC and BCLM treatment. GROUP 1 = resection; GROUP 2 = RFA. Overall survival from breast cancer treatment (months) p = 0.082 ns. Overall survival from BCLM treatment (months) p = 0.001 CONCLUSIONS: Aggressive treatment on isolated BCLM may improve survival for these patients.
