Surgical treatment of hepatic metastases from breast cancer

We have performed a retrospective study to evaluate whether surgical treatm ent is beneficial in patients with hepatic metastases from breast cancer. B etween September 1985 and September 1998, 25 patients with hepatic metastas es (14 solitary and 11 multiple), eight of whom had extrahepatic metastases , underwent hepatectomy. All of the detectable liver metastasis were resect ed in all of the cases. There were no severe postoperative complications. A ll but one of the patients received adjunctive polychemotherapy after the h epatectomy. After the hepatectomy, recurrent tumors were detected in 18 of the patients, being located in the liver in 12 (67%) of them. Overall, howe ver, hepatectomy ensured that the liver was clinically recurrence-free for a median of 24 months (range 2-132 months). Eleven patients died of recurre nt tumors, two died of other causes and the remaining 12 are currently aliv e. The 2- and 5-year cumulative survival rates after hepatectomy were 71% a nd 27%, respectively, and the median survival duration was 34.3 +/- 3.2 mon ths, much better than the period of 8.5 months for another series of patien ts treated with standard or non-surgical therapies at our institution. The number and the size of hepatic metastases, the interval between treatment o f the primary lesion and hepatectomy, and the existence of extrahepatic met astasis were not adverse prognostic factors. In conclusion, our data, altho ugh limited and highly selective, suggest that surgical treatment of hepati c metastases from breast cancer may prolong survival in certain subgroups o f patients to a greater extent than standard or non-surgical therapies.