The role of liver resection in patients with metastatic breast cancer: a systematic review examining the survival impact

Introduction Approximately 10% of breast cancer patients will present with solid organ metastases, while up to 30% will develop metastatic disease during their treatment course. Liver metastases are usually treated with systemic chemotherapy. Although colorectal liver metastases are routinely resect...

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Bibliographic Details
Published in:Irish journal of medical science 2018-11, Vol.187 (4), p.1009-1020
Main Authors: Tasleem, Sadia, Bolger, Jarlath C., Kelly, Michael E., Boland, Michael R., Bowden, Dermot, Sweeney, Karl J., Malone, Carmel
Format: Article
Language:English
Subjects:
Breast Neoplasms - mortality
Breast Neoplasms - pathology
Family Medicine
Female
General Practice
Hepatectomy - methods
Humans
Internal Medicine
Liver Neoplasms - mortality
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Medicine
Medicine & Public Health
Middle Aged
Review Article
Survival Rate
Treatment Outcome
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Summary:Introduction Approximately 10% of breast cancer patients will present with solid organ metastases, while up to 30% will develop metastatic disease during their treatment course. Liver metastases are usually treated with systemic chemotherapy. Although colorectal liver metastases are routinely resected, this is not yet the standard of care for breast cancer-related liver metastases. This review examines the evidence for resection of breast cancer-related liver metastases. Methods A systematic review identified 25 articles for inclusion, 12 papers concerning patients with isolated liver metastases, and 13 papers concerning patients with extrahepatic metastases. Data from 1080 patients were included. Results Two hundred eighty patients underwent hepatic resections for breast cancer-associated metastases with no extrahepatic metastases. Reported 5-year survival ranged from 24.6 to 78%. Median overall survival ranged from 29.5 to 116 months. For patients with oligometastatic disease undergoing resection, 5-year survival ranged from 21 to 57%, with median overall survival ranging from 32 to 58 months. Reported 30-day morbidity ranged from 14 to 42% for isolated and multiple metastases. Conclusion Hepatic resection can be considered in the management of breast cancer patients with isolated liver metastases as well as those with oligometastatic disease.
ISSN:0021-1265
1863-4362
DOI:10.1007/s11845-018-1746-9