Is liver resection justified for patients with hepatic metastases from breast cancer?
Is liver resection justified for patients with hepatic metastases from breast cancer?
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DOI：
10.1097/01.sla.0000246847.02058.1b
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发表时间：
2006-12-01
影响因子：
9
通讯作者：
Castaing, Denis
中科院分区：
文献类型：
--
作者：
Adam, Rene;Aloia, Thomas;Castaing, Denis
目的：本研究的目的是检验我们在一组相对未经选择的乳腺癌肝转移 (BCLM) 患者中进行肝切除 (HR) 的经验。背景：尽管药物治疗提供的生存获益有限（中位生存期为 3-15 个月），但将 HR 纳入 BCLM 患者的多模式治疗仍存在争议。我们的方法是向所有 BCLM 患者提供 HR，前提是治愈性肝切除可行，并且通过药物和/或手术治疗控制肝外疾病。方法：对 1984 年至 2004 年连续 85 名 BCLM 患者（均为女性，中位年龄 47 岁）接受 HR 治疗的结果进行了回顾。 27 名患者（32%）在 HR 之前已接受过肝外转移或同时存在肝外转移。 32 名患者 (38%) 为单发 BCLM，26 名患者 (31%) 数量超过 3 个。每个研究变量的预后价值均通过单变量分析的对数秩检验和多变量分析的 Cox 比例风险模型进行评估。结果：大肝切除术（>= 3 段，54 例患者）或小肝切除术（>= 3 段，54 例患者）后 60 天内（
Objective: The purpose of this study was to examine our experience with hepatic resection (HR) in a relatively unselected group of patients with breast cancer liver metastases (BCLM).Background: Although medical therapies provide limited survival benefit (median survival, 3-15 months), inclusion of HR into the multimodality treatment of patients with BCLM remains controversial. Our approach has been to offer HR to all patients with BCLM, provided that curative hepatic resection was feasible and extrahepatic disease was controlled with medical and/or surgical therapy.Methods: Outcomes for 85 consecutive patients (all female, median age, 47 years) with BCLM treated with HR from 1984 to 2004 were reviewed. Extrahepatic metastases had been treated prior to HR or were synchronously present in 27 patients (32%). BCLM were solitary in 32 patients (38%) and numbered more than 3 in 26 patients (31%). The prognostic value of each study variable was assessed with log rank tests for univariate analysis and Cox proportional hazard models for multivariate analysis.Results: Within 60 days of major hepatectomy (>= 3 segments, 54 patients) or minor hepatectomy (