Treatment for liver metastases from breast cancer: Results and prognostic factors
Treatment for liver metastases from breast cancer: Results and prognostic factors
复制标题
DOI：
10.3748/wjg.v11.i24.3782
复制
发表时间：
2005-06-28
影响因子：
4.3
通讯作者：
Li, Jie
中科院分区：
文献类型：
--
作者：
Li, Xiao-Ping;Meng, Zhi-Qiang;Li, Jie
目的：乳腺癌肝转移 (BCLM) 与不良预后相关。细胞毒性化疗可以导致肿瘤病变消退和症状减轻。文献中的现有数据也表明，一部分患者可能会从手术中受益，但很少有人谈论经导管动脉化疗栓塞术 (TACE)。我们报告乳腺癌肝转移患者的TACE和全身化疗的结果，并评估其预后因素。方法：1995年1月至2000年12月，48例确诊的乳腺癌肝转移患者接受TACE或全身化疗。根据WHO标准评估治疗结果，并使用Cox回归模型分析生存的预后因素。结果：中位随访时间为28个月（1-72 个月）。经计算，TACE 组和化疗组的有效率分别为 35.7% 和 7.1%。差异显着。 TACE组1年、2年、3年生存率分别为63.04%、30.35%、13.01%，全身化疗组分别为33.88%、11.29%、0%。根据单变量分析，与生存显着相关的变量是原发癌的淋巴结状态、肝转移的临床分期、Child-Pugh分级、体重减轻。其他因素如年龄、原发灶与转移灶之间的时间间隔、肝转移灶的最大直径、肝转移灶的数量、肝外转移灶等均无预后意义。上述因素如原发癌淋巴结状况、肝转移临床分期、Child-Pugh分级、体重减轻也是多因素分析中的独立因素。结论：TACE治疗乳腺癌肝转移可延长某些患者的生存期。这种方法为转移性乳腺癌患者的治疗提供了新的希望。 (C) 2005 The WJG Press 和 Elsevier Inc. 保留所有权利。
AIM: Liver metastases from breast cancer (BCLM) are associated with poor prognosis. Cytotoxic chemotherapy can result in regression of tumor lesions and a decrease in symptoms. Available data, in the literature, also suggest a subgroup of patients may benefit from surgery, but few talked about transcatheter arterial chemoembolization (TACE). We report the results of TACE and systemic chemotherapy for patients with liver metastases from breast cancer and evaluate the prognostic factors.METHODS: Forty-eight patients with liver metastases, from proved breast primary cancer were treated with TACE or systemic chemotherapy between January 1995 and December 2000. Treatment results were assessed according to WHO criteria, along with analysis of prognostic factors for survival using Cox regression model.RESULTS: The median follow-up was 28 mo (1-72 mo). Response rates were calculated for the TACE group and chemotherapy group, being 35.7% and 7.1%, respectively. The difference was significant. The one-, two- and three-year Survival rates for the TACE group were 63.04%, 30.35%, and 13.01%, and those for the systemic chemotherapy group were 33.88%, 11.29%, and 0%. According to univariate analysis, variables significantly associated with survival were the lymph node status of the primary cancer, the clinical stage of liver metastases, the Child-Pugh grade, loss of weight. Other factors such as age, the intervals between the primary to the metastases, the maximal diameter of the liver metastases, the number of liver metastases, extrahepatic metastasis showed no prognostic significances. These factors mentioned above such as the lymph node status of the primary cancer, the clinical stage of liver metastases, the Child-Pugh grade, loss of weight were also independent factors in multivariate analysis.CONCLUSION: TACE treatment of liver metastases from breast cancer may prolong survival in certain patients. This approach offers new promise for the curative treatment of the patients with metastatic breast cancer. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.