Survival analysis of hepatic resection for breast cancer metastases in Chinese women

Abstract

INTRODUCTION: The survival for patients with carcinoma of the breast with liver metastases remains very poor. The data on the survival outcome of this treatment modality in Chinese population is still lacking. METHOD: From Jan 2000 to Dec 2009, 557 patients received hepatectomy for liver metastases in our hospital. Total 14 patients received hepatectomy for breast cancer liver metastases (BCLM) in the University of Hong Kong. Short term outcome and long term survival were analyzed. RESULT: Nine patients (64.3%) received major hepatectomy and five patients (33.7%) received minor hepatectomy. The median blood loss was 330ml. There was no hospital mortality. The median hospital stay was 6.5 days. The median tumour size was 3cm (ranged 1.5 to 10cm). All the patients received R0 tumour resections. The median overall survival and five year survival following hepatectomy was 33 months (range 12.5 months to 134 months) and 45.1%. The median disease free survival and five year disease free survival following hepatectomy was 14 months (range 6.6 months to 75 months) and 27.7%. Univariate analysis showed that age of developing liver metastases< 41.5 year (p=0.044), triple negative receptor status on pathological examination (p= 0.047) and time to develop liver metastasis < 44.6 months from primary treatment (p=0.034) were associated with poor survival. Multivariate analysis showed that time to develop liver metastasis < 44.6 months from primary treatment was an independent significant factors for poor survival (p= 0.044 HR 0.785 CI 0.62-0.99). CONCLUSION: Liver resection for BCLM is a safe and effective method in the management of patients with cancer of the breast. Satisfactory short term and long term outcome can be achieved in Chinese populations. It should be considered more frequently as part of the multidisciplinary care of patient with breast cancer and liver metastases.