Resection of liver metastases from breast cancer

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dc.contributor.author Abbott, Daniel
dc.contributor.author Brouquet, Antoine
dc.contributor.author Mittendorf, Elizabeth
dc.contributor.author Andreou, Andreas
dc.contributor.author Meric-Bernstam, Funda
dc.contributor.author Valero, Vicente
dc.contributor.author Green, Marjorie
dc.contributor.author Kuerer, Henry
dc.contributor.author Curley, Steven
dc.contributor.author Vauthey, Jean-Nicolas
dc.contributor.author Abdalla, Eddie
dc.contributor.author Hunt, Kelly
dc.date.accessioned 2015-11-20T10:09:11Z
dc.date.available 2015-11-20T10:09:11Z
dc.date.copyright 2012
dc.date.issued 2015-11-20
dc.identifier.issn 0039-6060 en_US
dc.identifier.uri http://hdl.handle.net/10725/2649
dc.description.abstract 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. en_US
dc.language.iso en en_US
dc.title Resection of liver metastases from breast cancer en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Estrogen receptor status and response to chemotherapy before metastasectomy define outcome en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Surgery en_US
dc.journal.volume 151 en_US
dc.journal.issue 5 en_US
dc.article.pages 710-716 en_US
dc.identifier.doi http://dx.doi.org/10.1016/j.surg.2011.12.017 en_US
dc.identifier.ctation 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. en_US
dc.author.email eddie.abdalla@lau.edu.lb

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