Resection of liver metastases from breast cancer

Background The oncologic benefit of resecting liver metastases in patients with breast cancer is unclear. This study was performed to identify predictors of survival after hepatectomy. Methods Between 1997 and 2010, 86 patients underwent resection of breast cancer liver metastases. Clinicopathologic...

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Main Author: Abbott, Daniel (author)
Other Authors: Brouquet, Antoine (author), Mittendorf, Elizabeth (author), Andreou, Andreas (author), Meric-Bernstam, Funda (author), Valero, Vicente (author), Green, Marjorie (author), Kuerer, Henry (author), Curley, Steven (author), Vauthey, Jean-Nicolas (author), Abdalla, Eddie (author), Hunt, Kelly (author)
Format: article
Published: 2012
Online Access:http://hdl.handle.net/10725/2649
http://dx.doi.org/10.1016/j.surg.2011.12.017
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author Abbott, Daniel
author2 Brouquet, Antoine
Mittendorf, Elizabeth
Andreou, Andreas
Meric-Bernstam, Funda
Valero, Vicente
Green, Marjorie
Kuerer, Henry
Curley, Steven
Vauthey, Jean-Nicolas
Abdalla, Eddie
Hunt, Kelly
author2_role author
author
author
author
author
author
author
author
author
author
author
author_facet Abbott, Daniel
Brouquet, Antoine
Mittendorf, Elizabeth
Andreou, Andreas
Meric-Bernstam, Funda
Valero, Vicente
Green, Marjorie
Kuerer, Henry
Curley, Steven
Vauthey, Jean-Nicolas
Abdalla, Eddie
Hunt, Kelly
author_role author
dc.creator.none.fl_str_mv Abbott, Daniel
Brouquet, Antoine
Mittendorf, Elizabeth
Andreou, Andreas
Meric-Bernstam, Funda
Valero, Vicente
Green, Marjorie
Kuerer, Henry
Curley, Steven
Vauthey, Jean-Nicolas
Abdalla, Eddie
Hunt, Kelly
dc.date.none.fl_str_mv 2012
2015-11-20T10:09:11Z
2015-11-20T10:09:11Z
2015-11-20
dc.identifier.none.fl_str_mv 0039-6060
http://hdl.handle.net/10725/2649
http://dx.doi.org/10.1016/j.surg.2011.12.017
Abbott, D. E., Brouquet, A., Mittendorf, E. A., Andreou, A., Meric-Bernstam, F., Valero, V., ... & Vauthey, J. N. (2012). Resection of liver metastases from breast cancer: estrogen receptor status and response to chemotherapy before metastasectomy define outcome. Surgery, 151(5), 710-716.
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Surgery
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Resection of liver metastases from breast cancer
Estrogen receptor status and response to chemotherapy before metastasectomy define outcome
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description Background The oncologic benefit of resecting liver metastases in patients with breast cancer is unclear. This study was performed to identify predictors of survival after hepatectomy. Methods Between 1997 and 2010, 86 patients underwent resection of breast cancer liver metastases. Clinicopathologic characteristics of the primary breast neoplasm, timing of metastasis development, and treatment were recorded. Response to prehepatectomy chemotherapy was evaluated according to Response Criteria in Solid Tumors criteria, and the best response to chemotherapy during treatment and the response immediately before hepatectomy were noted. Univariate and multivariate analyses were performed to identify predictors of disease-free survival and overall survival. Results Fifty-nine patients (69%) had estrogen receptor– or progesterone receptor– positive primary breast neoplasms. Fifty-three patients (62%) had a solitary breast cancer liver metastasis, and 73 (85%) had breast cancer liver metastases ≤5 cm. Sixty-five patients (76%) received prehepatectomy hormonal and/or chemotherapy. Four patients (6%) had progressive disease as the best response, and 19 patients (30%) had progressive disease before hepatectomy (P < .001). Seventy percent of patients who received preoperative chemotherapy or hormonal therapy had either response or stable disease immediately before hepatectomy. No postoperative deaths were observed. At a 62-month median follow-up, the disease-free survival and overall survival were 14 and 57 months, respectively. On univariate analysis, estrogen receptor/progesterone receptor status of the primary breast neoplasm, best radiographic response, and preoperative radiographic response were associated with overall survival. On multivariate analysis, estrogen receptor–negative primary breast disease (P = .009; hazard ratio, 3.3; 95% confidence interval, 1.4–8.2) and preoperative progressive disease (P = .003; hazard ratio, 3.8; 95% confidence interval, 1.6–9.2) were associated with decreased overall survival. Conclusion Resection of breast cancer liver metastases in patients with estrogen receptor–positive disease that is responding to chemotherapy is associated with improved survival. The timing of operative intervention may be critical; resection before progression is associated with a better outcome.
eu_rights_str_mv openAccess
format article
id LAURepo_eb465f5a0af6ad2ec6c93cc4521ee7c1
identifier_str_mv 0039-6060
Abbott, D. E., Brouquet, A., Mittendorf, E. A., Andreou, A., Meric-Bernstam, F., Valero, V., ... & Vauthey, J. N. (2012). Resection of liver metastases from breast cancer: estrogen receptor status and response to chemotherapy before metastasectomy define outcome. Surgery, 151(5), 710-716.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
oai_identifier_str oai:laur.lau.edu.lb:10725/2649
publishDate 2012
repository.mail.fl_str_mv
repository.name.fl_str_mv
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spelling Resection of liver metastases from breast cancerEstrogen receptor status and response to chemotherapy before metastasectomy define outcomeAbbott, DanielBrouquet, AntoineMittendorf, ElizabethAndreou, AndreasMeric-Bernstam, FundaValero, VicenteGreen, MarjorieKuerer, HenryCurley, StevenVauthey, Jean-NicolasAbdalla, EddieHunt, KellyBackground The oncologic benefit of resecting liver metastases in patients with breast cancer is unclear. This study was performed to identify predictors of survival after hepatectomy. Methods Between 1997 and 2010, 86 patients underwent resection of breast cancer liver metastases. Clinicopathologic characteristics of the primary breast neoplasm, timing of metastasis development, and treatment were recorded. Response to prehepatectomy chemotherapy was evaluated according to Response Criteria in Solid Tumors criteria, and the best response to chemotherapy during treatment and the response immediately before hepatectomy were noted. Univariate and multivariate analyses were performed to identify predictors of disease-free survival and overall survival. Results Fifty-nine patients (69%) had estrogen receptor– or progesterone receptor– positive primary breast neoplasms. Fifty-three patients (62%) had a solitary breast cancer liver metastasis, and 73 (85%) had breast cancer liver metastases ≤5 cm. Sixty-five patients (76%) received prehepatectomy hormonal and/or chemotherapy. Four patients (6%) had progressive disease as the best response, and 19 patients (30%) had progressive disease before hepatectomy (P < .001). Seventy percent of patients who received preoperative chemotherapy or hormonal therapy had either response or stable disease immediately before hepatectomy. No postoperative deaths were observed. At a 62-month median follow-up, the disease-free survival and overall survival were 14 and 57 months, respectively. On univariate analysis, estrogen receptor/progesterone receptor status of the primary breast neoplasm, best radiographic response, and preoperative radiographic response were associated with overall survival. On multivariate analysis, estrogen receptor–negative primary breast disease (P = .009; hazard ratio, 3.3; 95% confidence interval, 1.4–8.2) and preoperative progressive disease (P = .003; hazard ratio, 3.8; 95% confidence interval, 1.6–9.2) were associated with decreased overall survival. Conclusion Resection of breast cancer liver metastases in patients with estrogen receptor–positive disease that is responding to chemotherapy is associated with improved survival. The timing of operative intervention may be critical; resection before progression is associated with a better outcome.PublishedN/A2015-11-20T10:09:11Z2015-11-20T10:09:11Z20122015-11-20Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0039-6060http://hdl.handle.net/10725/2649http://dx.doi.org/10.1016/j.surg.2011.12.017Abbott, D. E., Brouquet, A., Mittendorf, E. A., Andreou, A., Meric-Bernstam, F., Valero, V., ... & Vauthey, J. N. (2012). Resection of liver metastases from breast cancer: estrogen receptor status and response to chemotherapy before metastasectomy define outcome. Surgery, 151(5), 710-716.enSurgeryinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/26492019-02-26T10:55:17Z
spellingShingle Resection of liver metastases from breast cancer
Abbott, Daniel
status_str publishedVersion
title Resection of liver metastases from breast cancer
title_full Resection of liver metastases from breast cancer
title_fullStr Resection of liver metastases from breast cancer
title_full_unstemmed Resection of liver metastases from breast cancer
title_short Resection of liver metastases from breast cancer
title_sort Resection of liver metastases from breast cancer
url http://hdl.handle.net/10725/2649
http://dx.doi.org/10.1016/j.surg.2011.12.017