Surgical treatment of liver metastases from breast cancer,Trattamento chirurgico delle metastasi epatiche da tumore della mammella

Background. The prognosis of patients with hepatic metastases (HM) from breast cancer receiving no treatment is extremely poor. The aim of this study is to report results of liver resections for breast cancer liver metastases. Methods. Retrospective analysis of 17 women who underwent hepatic metastasectomy with curative intent in the Centre Léon-Bérard in Lyon and in the Department of General Surgery of University of Genoa. Results. The mean number of HM was 2.2 (range: 1-9). The following resections were performed: extended hepatectomies (7), hepatectomies (5), lobectomies (2) and segmentectomies (3). The median number of resected segments was 3 (range: 1-5). Perioperative complications occurred in only 1 patient (hepatic venous hypertension). Postoperative complications were seen in 5 patients: pleural effusion (3), pneumonia and fever (1) and biliary fistula (1). Nine patients developed recurrence discase: 6 patients died and 3 underwent a 2nd hepatic resection. One-year survival after hepatic resection was 92%, 2-year survival was 85%, 3-year survival was 52% and 5-year survival was 41% (Kaplan-Meier estimate). Conclusion. Our data, although limited, suggest that liver resection is a viable treatment option for selected patients that can be performed safely. It should be considered in individual patients if the operative risk is low, if no extrahepatic disease is present and provided a complete resection with clear margins is technically feasible.