Surgical treatment of breast cancer liver metastases - A nationwide registry-based case control study
| Autor: | Helena Taflin, Anne Andersson, Malin Sund, Oskar Hemmingsson, Marcus Sundén, Cecilia Hermansson |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Breast Neoplasms Resection Liver metastases 03 medical and health sciences Breast cancer 0302 clinical medicine medicine Hepatectomy Humans Prospective Studies Registries Neoplasm Metastasis Surgical treatment Aged Aged 80 and over Sweden Liver resection business.industry Kirurgi Patient Selection Liver Neoplasms Case-control study General Medicine Middle Aged Ablation medicine.disease Prognosis Oncology 030220 oncology & carcinogenesis Case-Control Studies 030211 gastroenterology & hepatology Surgery Female Radiology Morbidity business Liver ablation |
| Zdroj: | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 46(6) |
| ISSN: | 1532-2157 2009-2016 |
| Popis: | Introduction: The benefit of liver resection or ablation for breast cancer liver metastases (BCLM) remains unclear. The aim of the study was to determine survival after isolated BCLM in nationwide cohorts and compare surgical versus systemic treatment regimens. Materials and methods: The Swedish register for cancer in the liver and the bile ducts (SweLiv) and the National register for breast cancer (NBCR) was studied to identify patients with 1-5 BCLM without extrahepatic spread diagnosed 2009-2016. Data from the registers were validated and completed by review of medical records. A Kaplan-Meier plot and log rank test were used to analyse survival. Prognostic and predictive factors were evaluated by Cox regression analysis. Results: A surgical cohort (n = 29) was identified and compared to a control cohort (n = 33) receiving systemic treatment only. There was no 90-day mortality after surgery. Median survival from BCLM diagnosis was 77 months (95% CI 41-113) in the surgical cohort and 28 months (95% CI 13-43) in the control cohort, (p = 0.004). There was a longer disease-free interval and more oestrogen receptor positive tumours in the surgical cohort. Surgery was a significant positive predictive factor in univariate analysis while a multivariable analysis resulted in HR 0.478 (CI 0.193-1.181, p = 0.110) for surgical treatment. Conclusion: Surgery for BCLM is safe and might provide a survival benefit in selected patients but prospective trials are warranted to avoid selection bias. |
| Databáze: | OpenAIRE |
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