Autor(es):
Margonis, GA ; Buettner, S ; Sasaki, K ; Kim, Y ; Ratti, F ; Russolillo, N ; Ferrero, A ; Berger, N ; Gamblin, TC ; Poultsides, G ; Tran, T ; Postlewait, LM ; Maithel, S ; Michaels, AD ; Bauer, TW ; Pinto Marques, H ; Barroso, E ; Aldrighetti, L ; Pawlik, TM
Data: 2016
Identificador Persistente: http://hdl.handle.net/10400.17/3004
Origem: Repositório do Centro Hospitalar de Lisboa Central, EPE
Assunto(s): Aged; Breast Neoplasms; Databases, Factual; Female; Humans; Italy; Kaplan-Meier Estimate; Liver Neoplasms; Margins of Excision; Metastasectomy; Middle Aged; Multivariate Analysis; Portugal; Proportional Hazards Models; Risk Factors; Time Factors; Treatment Outcome; Tumor Burden; United States; Hepatectomy; CHLC CHBPT
Descrição
BACKGROUND: Data on surgical management of breast liver metastasis are limited. We sought to determine the safety and long-term outcome of patients undergoing hepatic resection of breast cancer liver metastases (BCLM). METHODS: Using a multi-institutional, international database, 131 patients who underwent surgery for BCLM between 1980 and 2014 were identified. Clinicopathologic and outcome data were collected and analyzed. RESULTS: Median tumor size of the primary breast cancer was 2.5 cm (IQR: 2.0-3.2); 58 (59.8%) patients had primary tumor nodal metastasis. The median time from diagnosis of breast cancer to metastasectomy was 34 months (IQR: 16.8-61.3). The mean size of the largest liver lesion was 3.0 cm (2.0-5.0); half of patients (52.0%) had a solitary metastasis. An R0 resection was achieved in most cases (90.8%). Postoperative morbidity and mortality were 22.8% and 0%, respectively. Median and 3-year overall-survival was 53.4 months and 75.2%, respectively. On multivariable analysis, positive surgical margin (HR 3.57, 95% CI 1.40-9.16; p = 0.008) and diameter of the BCLM (HR 1.03, 95% CI 1.01-1.06; p = 0.002) remained associated with worse OS. DISCUSSION: In selected patients, resection of breast cancer liver metastases can be done safely and a subset of patients may derive a relatively long survival, especially from a margin negative resection.
