Hepatic resection for liver metastases as part of the "Oncosurgical" treatment of metastatic breast cancer
Hepatic resection for liver metastases as part of the "Oncosurgical" treatment of metastatic breast cancer
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DOI：
10.1245/s10434-008-0072-2
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发表时间：
2008-10-01
影响因子：
3.7
通讯作者：
Charco, Ramon
中科院分区：
文献类型：
--
作者：
Caralt, Mireia;Bilbao, Itxarone;Charco, Ramon
背景：转移性乳腺癌被认为是一种无法治愈的疾病，尽管有新的治疗方法。最近的研究表明，肝切除与全身治疗相结合可以提高患者的生存率。患者和方法：患者的选择标准是：良好的身体状况，完整和安全的外科手术的可行性，没有不受控制的肝外转移。这些信息是前瞻性收集和回顾性分析从我们的数据库。结果：1988年至2006年间，12例转移性乳腺癌患者进行了13例肝脏切除术。同步转移2例，异时转移10例。1例患者在肝切除术时发生肝外骨转移。中位随访时间为35.9个月（12-113.4个月）。肝切除术的中位年龄为58.4岁（范围36-76岁）。住院时间中位数为8天（范围6-24天）；2例患者发生胆漏，无患者在术后死亡。7例（58.3%）出现肝脏复发。精算患者1年、3年和5年生存率分别为100%、79%和33%。在乳房手术后的前24个月内和后24个月内发生肝转移的患者，其1、3、5年精算生存率分别为100%、0%、0%、100%、83%和60% （P < 0.025）。结论：乳腺癌肝转移灶行肝切除在转移性乳腺癌肿瘤外科治疗中具有重要作用，3年生存率高。
Background: Metastatic breast cancer is considered an incurable disease despite new therapies. Recent studies suggest that liver resection associated with systemic treatment may improve patient survival.Patients and methods: Patient selection criteria were: good performance status, the feasibility of a complete and safe surgical procedure, and absence of uncontrolled extrahepatic metastases. The information was collected prospectively and analyzed retrospectively from our database.Results: Between 1988 and 2006, 13 liver resections were performed in 12 patients owing to metastatic breast cancer. Two patients had synchronous metastases and ten metachronous metastases. One patient had extrahepatic bone metastases at the time of liver resection. Median follow-up was 35.9 months (range 12-113.4 months). Median age at liver resection was 58.4 years (range 36-76 years). Median hospital stay was 8 days (range 6-24 days); two patients had biliary leak but none died during the postoperative course. Seven patients (58.3%) developed hepatic recurrence. One-, 3-, and 5-year actuarial patient survival was 100%, 79%, and 33%, respectively. Patients who developed liver metastases within the first 24 months and after the first 24 months post-breast surgery had 1-, 3-, and 5-year actuarial patient survival of 100%, 0%, and 0% and 100%, 83%, and 60%, respectively (P < 0.025).Conclusion: Liver resection for breast cancer liver metastases has an important role in the oncosurgical treatment of metastatic breast cancer with excellent 3-year survival.