Long-term outcomes after breast cancer liver metastasis surgery: A European, retrospective, snapshot study (LIBREAST STUDY)

Breast cancer (BC) is the most common malignant tumor in women. Between 20 % and 30 % of patients develop metastases from BC, 50 % of them in the liver. The mean survival rate reported in patients with liver metastases from BC (LMBC) ranges from 3 to 29 months. The role of surgery in LMBC is not clearly defined. The objective of the present study was to determine the long-term survival and disease-free survival of patients undergoing surgery for LMBC and to identify the patients who most likely benefit from surgery. This retrospective multicenter cohort study included all consecutive patients undergoing LMBC surgery at the participating European centers from January 1, 2010, to December 31, 2015. The ClinicalTrials.gov ID is NCT04817813. A hundred women (mean age 52.6 years) undergoing LMBC surgery were included. Five-year disease-free survival was 29 %, and 5-year overall survival was 60 %. Median survival after BC surgery was 12.4 years, and after LMBC surgery, 7 years. Patients with ECOG 1, ASA score I-II, metachronous LMBC, positive hormone receptors, and who had received neoadjuvant and adjuvant hormone treatment obtained the best overall and disease-free survival results. In cases of correct patient selection and as part of a comprehensive onco-surgical strategy, surgery for LMBC improves overall long-term survival. In our series, certain factors were linked to better disease-free and overall survival; consideration of these factors could improve the selection of the best candidates for LMBC surgery. NCT04817813. •Breast cancer is the most common malignant tumor among women and is the second leading cause of tumor mortality in women worldwide. Between 20 and 30 % of cases develop metastasis, and 50 % are located in the liver.•Given the scarcity of published series on patients undergoing surgery for liver metastases from breast cancer and the limited data on the long-term results, this study aimed to assess long-term overall survival and disease-free survival, relapse, and death to determine which patients are most likely to benefit from surgery.•Our data suggest that the patients who will benefit the most from surgical treatment are the ones with ECOG 1, ASA score I-II, and positive hormone receptors (Luminal A and B) who have received neoadjuvant and adjuvant hormone therapy since they presented less disease recurrence and higher overall and disease-free survival. The 5-year DFS was 29 % and the OS 60 %, with a median survival of 7 years after surgi