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Comparative Study
. 2020 Jul;9(13):4656-4666.
doi: 10.1002/cam4.3117. Epub 2020 May 12.

The role of surgical intervention for isolated breast cancer liver metastasis: Results of case-control study with comparison to medical treatment

Jiahuai Wen  1   2 , Feng Ye  3 , Fengfeng Xie  1 , Dan Liu  1 , LeZhen Huang  1 , Chen Fang  1 , Shaowen Zhong  1 , Liping Ren  1
Affiliations
Comparative Study

The role of surgical intervention for isolated breast cancer liver metastasis: Results of case-control study with comparison to medical treatment

Jiahuai Wen et al. Cancer Med. 2020 Jul.

Abstract

Background: Combined with systemic therapy, the surgical intervention for breast cancer liver metastases (BCLM) is increasingly accepted but lacks convincing evidence. The aim of this study was to evaluate the disease control efficacy of hepatic surgery in isolated BCLM patients.

Methods: Between 2012 and 2017, metastatic breast cancer patients with isolated liver metastasis and regular follow-up were identified. Cohort design was conducted to compare the progression-free survival (PFS) between the surgical and nonsurgical BCLM patients. Univariate analysis and multivariate Cox regression survival analyses were performed to identify significant prognostic factors.

Result: In all, 148 isolated BCLM patients were enrolled and 95 participants received hepatic surgery for metastatic lesions. With median follow-up of 36.47 months, there was no significant difference between hepatic surgical group and nonsurgical group for PFS (median PFS: 11.17 months vs 10.10 m, P = .092). Based on the multivariate analysis, the disease-free interval (DFI) was an independent prognostic factor for isolated BCLM patients. Among the surgical group, BCLM patients who had ideal response after first salvage systemic treatment experienced the best long-term survival (median PFS: 14.20 months).

Conclusion: For isolated BCLM patients with ideal response in first-line medical treatment, surgical intervention (hepatectomy, radiofrequency ablation) combining with systemic treatment could bring improved progression-free survival compared to sole systemic treatment, indicating that hepatic surgery may be considered as a therapeutic choice for selected isolated BCLM patients in clinical practice.

Keywords: breast cancer; liver metastasis; surgical intervention.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Progression‐free survival comparison between systemic treatment plus surgical intervention (surgical group) and sole systemic treatment (nonsurgical group) for patients with isolated breast cancer liver metastasis
FIGURE 2
FIGURE 2
Subgroup analyses of progression‐free survival for isolated breast cancer liver metastasis patients. A, ER/PR‐positive, (B) ER/PR‐negative, (C)HER2‐positive, (D)HER2‐negative, (E) Preliminary stage 1‐3, (F) Preliminary stage 4, (G) DFI ≤24 mo, and (H) DFI >24 mo
FIGURE 3
FIGURE 3
The combined effect of hepatic surgical intervention and preoperative therapeutic evaluation among isolated BCLM patients
FIGURE 4
FIGURE 4
The subgroup analyses of progression‐free survival for isolated breast cancer liver metastasis patients. A, ER/PR‐positive, (B) ER/PR‐negative, (C) HER2‐positive, and (D) HER2‐negative
See this image and copyright information in PMC

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