Resection of liver metastases from breast cancer: a multicentre analysis
Resection of liver metastases from breast cancer: a multicentre analysis
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乳腺癌肝转移切除：多中心分析
DOI：
10.1007/s12094-019-02155-2
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发表时间：
2020-04-01
影响因子：
3.4
通讯作者：
Shao, Z.
中科院分区：
文献类型：
--
作者：
He, X.;Zhang, Q.;Shao, Z.
在改善乳腺癌转移（BCLM）患者的不良预后，背景手术变得越来越实用和有效。但是，没有一套公认的标准来确定将从手术中受益的BCLM候选人。在2018年1月至2018年9月之间，在本研究中选择了67例接受部分肝切除术的女性BCLM患者进行分析。确定肝切除术后的预后因素。进行单变量和多元分析，以识别总生存期（OS）和肝内无复发生存（IHRF）的预测指标。结果，接受手术治疗的患者的1年，3年和5年OS分别为93.5％，73.7％和32.2％，中位生存时间为57.59个月。 Pringle机动[危险无线电（HR）= 0.117，95％CI0.015-0.942，P = 0.044]，乳房手术和BCLM诊断之间的间隔增加（HR0.178，95％CI 0.037-0.869，P = 0.033），P = 0.033）独立预测BCLM患者的总体生存率提高。接受手术的患者的1年，2和3年IHRF分别为62.8％，32.6％和10.9％，中位无复发性生存时间为13.47个月。适度分化的肿瘤（HR 0.259，95％CI 0.078-0.857，p = 0.027）和乳房转移的发育超过2年后，乳房手术后2年以上（HR 0.270，95％CI 0.108-0.675，P = 0.005）可能是预测的增加了IHRF。结论在乳腺癌手术和肝转移之间超过2年的间隔似乎是BCLM患者肝脏手术的指示。 Pringle操纵和中等分化的肿瘤分别是与OS和IHRF相关的潜在预测因子，这是肝切除术的益处。有必要使用增加样本量的研究来验证我们的结果。
BackgroundSurgery is becoming more practical and effective than conservative treatment in improving the poor outcomes of patients with breast cancer liver metastasis (BCLM). However, there is no generally acknowledged set of standards for identifying BCLM candidates who will benefit from surgery.MethodsBetween January 2011 and September 2018, 67 female BCLM patients who underwent partial hepatectomy were selected for analysis in the present study. Prognostic factors after hepatectomy were determined. Univariate and multivariate analyses were performed to identify predictors of overall survival (OS) and intrahepatic recurrence-free survival (IHRFS).ResultsThe 1-, 3- and 5-year OS of patients treated with surgery was 93.5%, 73.7% and 32.2%, respectively, with a median survival time of 57.59 months. The Pringle manoeuvre [hazard radio (HR) = 0.117, 95% CI0.015–0.942,p= 0.044] and an increased interval between breast surgery and BCLM diagnosis (HR0.178, 95% CI 0.037–0.869,p= 0.033) independently predicted improved overall survival for BCLM patients. The 1-, 2- and 3-year IHRFS of patients who underwent surgery was 62.8, 32.6% and 10.9%, respectively, with a median intrahepatic recurrence-free survival time of 13.47 months. Moderately differentiated tumours (HR 0.259, 95% CI 0.078–0.857,p= 0.027) and the development of liver metastasis more than 2 years after breast surgery (HR 0.270, 95% CI 0.108–0.675,p= 0.005) might be predictors of increased IHRFS.ConclusionsAn interval of more than 2 years between breast cancer surgery and liver metastasis seems to be an indication of liver surgery in BCLM patients. The Pringle manoeuvre and moderately differentiated tumours are potential predictors associated with OS and IHRFS, respectively, as benefits from liver resection. Studies with increased sample sizes are warranted to validate our results.