Prognostic factors for patients with liver metastases from breast cancer

Abstract

Background: The prognosis of patients with liver metastases from breast cancer is commonly poor. After initial diagnosis of hepatic metastases, a median survival time of 1-20 months can be expected. The definition of prognostic factors for such patients may influence therapeutic decisions. In particular, the characterization of patients who can expect long-term survival could assist in optimizing treatment.

Methods: We retrospectively studied n = 350 patients with liver metastases from breast cancer. All patients were stratified following their survival after occurrence of liver metastases. Kaplan-Meier studies were performed, as well as univariate and multivariate analyses of several clinical, histopathological and therapeutic factors.

Results: Median survival time was 14 months. N = 66 (18.9%) patients survived longer than 36 months after the primary diagnosis. Multivariate analysis showed prognostic relevance for the time interval between the primary diagnosis of breast cancer and the initial diagnosis of hepatic metastases (p < 0.05). Furthermore, prognostic relevance was found for the pattern of metastasization (p < 0.05) and for signs of hepatic dysfunction (ascites, jaundice, p < 0.005). Univariate analysis showed a prognostic benefit for patients with an expression of Ki-67 < 20%, p53 < 50% and a positive hormonal receptor status. Patients who received a regional therapy survived on average longer than patients who were only treated systemically (33 versus 11 months, p < 0.001).

Conclusions: Consideration of prognostic implications of the described parameters may help to find the most appropriate treatment for patients with liver metastases from breast cancer. The possibility of local therapeutic interventions should be considered in a defined subgroup.