Hepatic resection or ablation for isolated breast cancer liver metastasis: A case-control study with comparison to medically treated patients Journal Article

Authors: Sadot, E.; Lee, S. Y.; Sofocleous, C. T.; Solomon, S. B.; Gönen, M.; Kingham, T. P.; Allen, P. J.; DeMatteo, R. P.; Jarnagin, W. R.; Hudis, C. A.; D'Angelica, M. I.
Article Title: Hepatic resection or ablation for isolated breast cancer liver metastasis: A case-control study with comparison to medically treated patients
Abstract: Objective: To evaluate the efficacy of surgical treatment for patients with isolated breast cancer liver metastases (BCLM). Background: Single-arm retrospective studies have shown promising results associated with surgery for isolated BCLM; however, this treatment remains controversial and its role is not well-defined. Methods: A review of 2150 patients with BCLM who underwent treatment in a single institution was conducted, and 167 (8%) patients with isolated BCLM were identified. A case-control study was conducted to compare outcomes in patients with isolated BCLM who underwent surgery and/or ablation to patients who underwent conventional medical therapy. Results: A total of 167 patients were included (surgery/ablation: 69; medical: 98), with a median follow-up for survivors of 73 months. Patients in the surgical cohort more frequently had estrogen receptor-positive tumors and received adjuvant chemotherapy and radiotherapy for their primary breast tumor. The hepatic tumor burden was less and the interval from breast cancer diagnosis to BCLM was significantly longer (53 vs 30 months) in the surgical cohort. Patients undergoing surgical treatment had a median recurrence-free interval of 28.5 months (95% confidence interval (CI): 19-38) with 10 patients (15%) recurrence free after 5 years. There was no significant difference in overall survival (OS) between the surgical and medical cohorts (median OS: 50 vs 45 months; 5-year OS: 38% vs 39%). Conclusions: Hepatic resection and/or ablation was not associated with a survival advantage. However, significant recurrence-free intervals can be accomplished with surgical treatment. Surgical intervention might be considered in highly selected patients with the goal of providing time off of systemic chemotherapy.
Keywords: survival; metastasis; statistics; breast; recurrence; liver; hepatectomy; resection; radiofrequency ablation; guidelines; management; prognostic-factors; estrogen-receptor; cancer; receptor conversion
Journal Title: Annals of Surgery
Volume: 264
Issue: 1
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2016-07-01
Start Page: 147
End Page: 154
Language: English
ACCESSION: WOS:000377769600026
DOI: 10.1097/sla.0000000000001371
PMCID: PMC4818209
PUBMED: 26445472
Notes: Article -- Source: Wos
Citation Impact
MSK Authors
  1. Clifford Hudis
    902 Hudis
  2. Ronald P DeMatteo
    636 DeMatteo
  3. Mithat Gonen
    884 Gonen
  4. Peter Allen
    499 Allen
  5. William R Jarnagin
    740 Jarnagin
  6. T Peter Kingham
    430 Kingham
  7. Stephen Solomon
    366 Solomon
  8. Ser Yee Lee
    9 Lee
  9. Eran Sadot
    38 Sadot