Hepatic Resection for Breast Cancer Liver Metastases

Aim: To review the experience of a single Oncological Surgery Centre regarding the benefit of hepatic resection in breast cancer liver metastases (BCLM) patients with unique focus in overall survival rate, and compare these results with matched individuals of other group of BCLM patients treated only with chemotherapy and/or hormonal regimens. Patients and methods: Between July 2007 and July 2015, a total of 260 female patients with BCLM were entered prospectively into a database of our Surgical Oncological Centre, and were all evaluated by their Multidisciplinary Team. Two groups of patients were enlisted: 1) Surgical Group (SG) enrolled by 36 patients which were suitable to receive a hepatic resection; 2) Non-Surgical Group (NSG) integrated by 20 that could receive medical treatment alone. Patients with 5 or more liver metastases and/or uncontrolled extra hepatic metastatic disease were excluded in this series. However, patients with slight extra hepatic disease that were treated and were deemed stable or certainly improving were included. Results: Concerning with SG there was no postoperative mortality and perioperative complications occurred in 11 out of 36 patients (30.5%). Histopathological examination confirmed in all cases free tumor margin (R0). Followup of 100% for all patients. Median overall survival was 55.2 months in the SG vs 23.6 months in the NSG. Actuarial 1-year, 3-year and 5-year survival rates were 100%, 84% and 61.6% respectively in the SG vs 65%, 28% and 0% respectively in the NSG (p=0.000). Conclusions: Surgical treatment is only indicated in a select group of patients and can improve long-term outcomes. In this study, significantly better survival rates were observed in the surgical group that encourage continuing in this line of multimodal treatment. Surgical therapy can act as an effective adjuvant treatment to systemic therapies, providing selected patients a survival benefit as well as the hope for cure.