Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/3004
Título: The Role of Liver-Directed Surgery in Patients With Hepatic Metastasis From Primary Breast Cancer: a Multi-Institutional Analysis
Autor: 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
Palavras-chave: 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
Data: 2016
Editora: Elsevier
Citação: HPB (Oxford). 2016 Aug;18(8):700-5.
Resumo: 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.
Peer review: yes
URI: http://hdl.handle.net/10400.17/3004
DOI: 10.1016/j.hpb.2016.05.014
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