%0 Journal Article
%T Liver Resections of Isolated Liver Metastasis in Breast Cancer: Results and Possible Prognostic Factors
%A Malte Weinrich
%A Christel Weiˋ
%A Jochen Schuld
%A Bettina M. Rau
%J HPB Surgery
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/893829
%X Background. Breast cancer liver metastasis is a hematogenous spread of the primary tumour. It can, however, be the expression of an isolated recurrence. Surgical resection is often possible but controversial. Methods. We report on 29 female patients treated operatively due to isolated breast cancer liver metastasis over a period of six years. Prior to surgery all metastases appeared resectable. Liver metastasis had been diagnosed 55 (median, range 1每177) months after primary surgery. Results. Complete resection of the metastases was performed in 21 cases. The intraoperative staging did not confirm the preoperative radiological findings in 14 cases, which did not generally lead to inoperability. One-year survival rate was 86% in resected patients and 37.5% in nonresected patients. Significant prognostic factors were R0 resection, low T- and N-stages as well as a low-grade histopathology of the primary tumour, lower number of liver metastases, and a longer time interval between primary surgery and the occurrence of liver metastasis. Conclusions. Complete resection of metastases was possible in three-quarters of the patients. Some of the studied factors showed a prognostic value and therefore might influence indication for resection in the future. 1. Introduction Metastasis is the most common cause of death in cancer patients [1]. Breast cancer might spread via blood stream and cause liver metastasis. This can arise simultaneously or decades after the primary tumour. Metastases are often the sole sign of recurrence of the breast cancer. References show that 2每12% of patients with breast cancer have liver metastasis [2, 3], which, however, might be isolated in some cases. In patients with resectable colorectal liver metastasis, surgical resection is the only curative approach, if an additional nonresectable extrahepatic tumour is excluded. References report 5-year survival rates of 30 to 47% in these patients [4每7]. Surgical management is therefore recommended in the German S3-guidelines for colorectal cancer [8]. In contrast to this the data on isolated liver metastasis in breast cancer patients is not as explicit. After the release of the initial study on resection of noncolorectal nonneuroendocrine liver metastases [9], innumerous similar studies followed [10每15]. The large range of tumour entities including patients with breast cancer is the common denominator of these studies. Breast cancer, however, represents only a minor share in the tumours examined and is stated to have a comparably good prognosis [10, 12每15]. The survival rates are reported to be
%U http://www.hindawi.com/journals/hpb/2014/893829/