Evolving Role of Liver Resection in Selected Patients With Metastatic Breast Cancer
More effective chemotherapy regimens combined with metastasectomy have improved overall survival (OS) in several cancer populations. The value of liver resection (LR) in breast cancer liver metastasis (BCLM) remains controversial. We sought to investigate the role of LR in BCLM as a therapeutic opti...
Gespeichert in:
| Veröffentlicht in: | The Journal of surgical research 2021-03, Vol.259, p.363-371 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 371 |
|---|---|
| container_issue | |
| container_start_page | 363 |
| container_title | The Journal of surgical research |
| container_volume | 259 |
| creator | Millen, Janelle-Cheri A. Hofmann, Alana Mesquita-Neto, Jose Wilson Rose, Jeffrey Macedo, Francis I. |
| description | More effective chemotherapy regimens combined with metastasectomy have improved overall survival (OS) in several cancer populations. The value of liver resection (LR) in breast cancer liver metastasis (BCLM) remains controversial. We sought to investigate the role of LR in BCLM as a therapeutic option in patients with isolated liver metastasis.
The National Cancer Data Base (NCDB) was queried for patients with BCLM diagnosed from 2010 to 2014. The primary outcome was the OS. Kaplan–Meier and Cox proportional hazards regression were performed for intergroup comparison.
A total of 9244 patients with BCLM were included. The median age was 58 y (IQR 49-68 y). Of them, 2632 (28.5%) patients had isolated liver metastasis, 1957 (78.2%) received chemotherapy, 93 (3.6%) underwent LR, and only 83 (3.2%) received chemotherapy and LR. Median OS for the entire cohort and for patients with isolated BCLM was 18.3 mo and 29 mo, respectively. Chemotherapy with LR was associated with superior OS compared to chemotherapy alone (69.7 versus 49.2 mo, P |
| doi_str_mv | 10.1016/j.jss.2020.09.022 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2460998679</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022480420306855</els_id><sourcerecordid>2460998679</sourcerecordid><originalsourceid>FETCH-LOGICAL-c353t-1f31e87da753e2c6daa4e9235dcb5e707064eb40e3d94e3c327820c79588a9473</originalsourceid><addsrcrecordid>eNp9kM1OwzAQhC0EoqXwAFyQj1wS1nYSx-IEVfmRikAtiKPlOltwlSbFTivx9rhq4chpd0czI-1HyDmDlAErrhbpIoSUA4cUVAqcH5A-A5UnZSHFIelDlJKshKxHTkJYQLyVFMekJwQrlSigT6ajTVtvXPNBJ22NtJ3TsdugpxMMaDvXNtQ1dIp1PLCiL6Zz2HSBvrvukz5hZ0IXJUtvPcaVDk1j0Z-So7mpA57t54C83Y1ehw_J-Pn-cXgzTqzIRZewuWBYysrIXCC3RWVMhoqLvLKzHCVIKDKcZYCiUhkKK7gsOVip8rI0KpNiQC53vSvffq0xdHrpgsW6Ng2266B5VoBSkYWKVrazWt-G4HGuV94tjf_WDPSWpV7oyFJvWWpQOoKLmYt9_Xq2xOov8QsvGq53BoxPbhx6HWzEY7FyPvLSVev-qf8Bf86Dtw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2460998679</pqid></control><display><type>article</type><title>Evolving Role of Liver Resection in Selected Patients With Metastatic Breast Cancer</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Millen, Janelle-Cheri A. ; Hofmann, Alana ; Mesquita-Neto, Jose Wilson ; Rose, Jeffrey ; Macedo, Francis I.</creator><creatorcontrib>Millen, Janelle-Cheri A. ; Hofmann, Alana ; Mesquita-Neto, Jose Wilson ; Rose, Jeffrey ; Macedo, Francis I.</creatorcontrib><description>More effective chemotherapy regimens combined with metastasectomy have improved overall survival (OS) in several cancer populations. The value of liver resection (LR) in breast cancer liver metastasis (BCLM) remains controversial. We sought to investigate the role of LR in BCLM as a therapeutic option in patients with isolated liver metastasis.
The National Cancer Data Base (NCDB) was queried for patients with BCLM diagnosed from 2010 to 2014. The primary outcome was the OS. Kaplan–Meier and Cox proportional hazards regression were performed for intergroup comparison.
A total of 9244 patients with BCLM were included. The median age was 58 y (IQR 49-68 y). Of them, 2632 (28.5%) patients had isolated liver metastasis, 1957 (78.2%) received chemotherapy, 93 (3.6%) underwent LR, and only 83 (3.2%) received chemotherapy and LR. Median OS for the entire cohort and for patients with isolated BCLM was 18.3 mo and 29 mo, respectively. Chemotherapy with LR was associated with superior OS compared to chemotherapy alone (69.7 versus 49.2 mo, P < 0.001) in patients with BCLM: ER+ (69.6 versus 54.1 mo, P = 0.002) and triple-negative BC (49.2 versus 17.6 mo, P = 0.006). Cox regression showed that LR, chemotherapy, and positive hormone receptor status (ER+, PR+, and/or HER2+) were independent predictors of improved OS. Advanced age and comorbidity score negatively impacted OS.
This is the largest series thus far assessing the role of LR in patients with BCLM. LR plus chemotherapy may be associated with acceptable outcomes in selected patients with BCLM. LR should be considered in patients with isolated BCLM who had a good response to systemic therapy.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2020.09.022</identifier><identifier>PMID: 33189360</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Breast - pathology ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - therapy ; Chemotherapy ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Kaplan-Meier Estimate ; Liver - pathology ; Liver - surgery ; Liver Neoplasms - mortality ; Liver Neoplasms - secondary ; Liver Neoplasms - therapy ; Mastectomy ; Metastasectomy ; Metastasectomy - methods ; Middle Aged ; Overall survival ; Patient Selection ; Retrospective Studies ; Stage 4 breast cancer ; Treatment Outcome</subject><ispartof>The Journal of surgical research, 2021-03, Vol.259, p.363-371</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-1f31e87da753e2c6daa4e9235dcb5e707064eb40e3d94e3c327820c79588a9473</citedby><cites>FETCH-LOGICAL-c353t-1f31e87da753e2c6daa4e9235dcb5e707064eb40e3d94e3c327820c79588a9473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2020.09.022$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33189360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Millen, Janelle-Cheri A.</creatorcontrib><creatorcontrib>Hofmann, Alana</creatorcontrib><creatorcontrib>Mesquita-Neto, Jose Wilson</creatorcontrib><creatorcontrib>Rose, Jeffrey</creatorcontrib><creatorcontrib>Macedo, Francis I.</creatorcontrib><title>Evolving Role of Liver Resection in Selected Patients With Metastatic Breast Cancer</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>More effective chemotherapy regimens combined with metastasectomy have improved overall survival (OS) in several cancer populations. The value of liver resection (LR) in breast cancer liver metastasis (BCLM) remains controversial. We sought to investigate the role of LR in BCLM as a therapeutic option in patients with isolated liver metastasis.
The National Cancer Data Base (NCDB) was queried for patients with BCLM diagnosed from 2010 to 2014. The primary outcome was the OS. Kaplan–Meier and Cox proportional hazards regression were performed for intergroup comparison.
A total of 9244 patients with BCLM were included. The median age was 58 y (IQR 49-68 y). Of them, 2632 (28.5%) patients had isolated liver metastasis, 1957 (78.2%) received chemotherapy, 93 (3.6%) underwent LR, and only 83 (3.2%) received chemotherapy and LR. Median OS for the entire cohort and for patients with isolated BCLM was 18.3 mo and 29 mo, respectively. Chemotherapy with LR was associated with superior OS compared to chemotherapy alone (69.7 versus 49.2 mo, P < 0.001) in patients with BCLM: ER+ (69.6 versus 54.1 mo, P = 0.002) and triple-negative BC (49.2 versus 17.6 mo, P = 0.006). Cox regression showed that LR, chemotherapy, and positive hormone receptor status (ER+, PR+, and/or HER2+) were independent predictors of improved OS. Advanced age and comorbidity score negatively impacted OS.
This is the largest series thus far assessing the role of LR in patients with BCLM. LR plus chemotherapy may be associated with acceptable outcomes in selected patients with BCLM. LR should be considered in patients with isolated BCLM who had a good response to systemic therapy.</description><subject>Adult</subject><subject>Aged</subject><subject>Breast - pathology</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - therapy</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hepatectomy</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Liver - pathology</subject><subject>Liver - surgery</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - therapy</subject><subject>Mastectomy</subject><subject>Metastasectomy</subject><subject>Metastasectomy - methods</subject><subject>Middle Aged</subject><subject>Overall survival</subject><subject>Patient Selection</subject><subject>Retrospective Studies</subject><subject>Stage 4 breast cancer</subject><subject>Treatment Outcome</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1OwzAQhC0EoqXwAFyQj1wS1nYSx-IEVfmRikAtiKPlOltwlSbFTivx9rhq4chpd0czI-1HyDmDlAErrhbpIoSUA4cUVAqcH5A-A5UnZSHFIelDlJKshKxHTkJYQLyVFMekJwQrlSigT6ajTVtvXPNBJ22NtJ3TsdugpxMMaDvXNtQ1dIp1PLCiL6Zz2HSBvrvukz5hZ0IXJUtvPcaVDk1j0Z-So7mpA57t54C83Y1ehw_J-Pn-cXgzTqzIRZewuWBYysrIXCC3RWVMhoqLvLKzHCVIKDKcZYCiUhkKK7gsOVip8rI0KpNiQC53vSvffq0xdHrpgsW6Ng2266B5VoBSkYWKVrazWt-G4HGuV94tjf_WDPSWpV7oyFJvWWpQOoKLmYt9_Xq2xOov8QsvGq53BoxPbhx6HWzEY7FyPvLSVev-qf8Bf86Dtw</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Millen, Janelle-Cheri A.</creator><creator>Hofmann, Alana</creator><creator>Mesquita-Neto, Jose Wilson</creator><creator>Rose, Jeffrey</creator><creator>Macedo, Francis I.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202103</creationdate><title>Evolving Role of Liver Resection in Selected Patients With Metastatic Breast Cancer</title><author>Millen, Janelle-Cheri A. ; Hofmann, Alana ; Mesquita-Neto, Jose Wilson ; Rose, Jeffrey ; Macedo, Francis I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-1f31e87da753e2c6daa4e9235dcb5e707064eb40e3d94e3c327820c79588a9473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Breast - pathology</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - therapy</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hepatectomy</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Liver - pathology</topic><topic>Liver - surgery</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - secondary</topic><topic>Liver Neoplasms - therapy</topic><topic>Mastectomy</topic><topic>Metastasectomy</topic><topic>Metastasectomy - methods</topic><topic>Middle Aged</topic><topic>Overall survival</topic><topic>Patient Selection</topic><topic>Retrospective Studies</topic><topic>Stage 4 breast cancer</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Millen, Janelle-Cheri A.</creatorcontrib><creatorcontrib>Hofmann, Alana</creatorcontrib><creatorcontrib>Mesquita-Neto, Jose Wilson</creatorcontrib><creatorcontrib>Rose, Jeffrey</creatorcontrib><creatorcontrib>Macedo, Francis I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Millen, Janelle-Cheri A.</au><au>Hofmann, Alana</au><au>Mesquita-Neto, Jose Wilson</au><au>Rose, Jeffrey</au><au>Macedo, Francis I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolving Role of Liver Resection in Selected Patients With Metastatic Breast Cancer</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2021-03</date><risdate>2021</risdate><volume>259</volume><spage>363</spage><epage>371</epage><pages>363-371</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>More effective chemotherapy regimens combined with metastasectomy have improved overall survival (OS) in several cancer populations. The value of liver resection (LR) in breast cancer liver metastasis (BCLM) remains controversial. We sought to investigate the role of LR in BCLM as a therapeutic option in patients with isolated liver metastasis.
The National Cancer Data Base (NCDB) was queried for patients with BCLM diagnosed from 2010 to 2014. The primary outcome was the OS. Kaplan–Meier and Cox proportional hazards regression were performed for intergroup comparison.
A total of 9244 patients with BCLM were included. The median age was 58 y (IQR 49-68 y). Of them, 2632 (28.5%) patients had isolated liver metastasis, 1957 (78.2%) received chemotherapy, 93 (3.6%) underwent LR, and only 83 (3.2%) received chemotherapy and LR. Median OS for the entire cohort and for patients with isolated BCLM was 18.3 mo and 29 mo, respectively. Chemotherapy with LR was associated with superior OS compared to chemotherapy alone (69.7 versus 49.2 mo, P < 0.001) in patients with BCLM: ER+ (69.6 versus 54.1 mo, P = 0.002) and triple-negative BC (49.2 versus 17.6 mo, P = 0.006). Cox regression showed that LR, chemotherapy, and positive hormone receptor status (ER+, PR+, and/or HER2+) were independent predictors of improved OS. Advanced age and comorbidity score negatively impacted OS.
This is the largest series thus far assessing the role of LR in patients with BCLM. LR plus chemotherapy may be associated with acceptable outcomes in selected patients with BCLM. LR should be considered in patients with isolated BCLM who had a good response to systemic therapy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33189360</pmid><doi>10.1016/j.jss.2020.09.022</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-4804 |
| ispartof | The Journal of surgical research, 2021-03, Vol.259, p.363-371 |
| issn | 0022-4804 1095-8673 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2460998679 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Aged Breast - pathology Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - therapy Chemotherapy Chemotherapy, Adjuvant Female Follow-Up Studies Hepatectomy Humans Kaplan-Meier Estimate Liver - pathology Liver - surgery Liver Neoplasms - mortality Liver Neoplasms - secondary Liver Neoplasms - therapy Mastectomy Metastasectomy Metastasectomy - methods Middle Aged Overall survival Patient Selection Retrospective Studies Stage 4 breast cancer Treatment Outcome |
| title | Evolving Role of Liver Resection in Selected Patients With Metastatic Breast Cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T01%3A54%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evolving%20Role%20of%20Liver%20Resection%20in%20Selected%20Patients%20With%20Metastatic%20Breast%20Cancer&rft.jtitle=The%20Journal%20of%20surgical%20research&rft.au=Millen,%20Janelle-Cheri%20A.&rft.date=2021-03&rft.volume=259&rft.spage=363&rft.epage=371&rft.pages=363-371&rft.issn=0022-4804&rft.eissn=1095-8673&rft_id=info:doi/10.1016/j.jss.2020.09.022&rft_dat=%3Cproquest_cross%3E2460998679%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2460998679&rft_id=info:pmid/33189360&rft_els_id=S0022480420306855&rfr_iscdi=true |