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Liu S, Jia Y, Chai J, Ge H, Huang R, Li A, Cheng H. A Predictive Model for the Early Death of Breast Cancer With Synchronous Liver Metastases: A Population-Based Study. Cancer Control 2023; 30:10732748231202851. [PMID: 37724916 PMCID: PMC10510350 DOI: 10.1177/10732748231202851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/29/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Breast cancer liver metastasis (BCLM) is a severe condition often resulting in early death. The identification of prognostic factors and the construction of accurate predictive models can guide clinical decision-making. METHODS A large sample of data from the Surveillance, Epidemiology, and End Results (SEER) database was analyzed, including 3711 patients diagnosed with de novo BCLM between 2010 and 2015. Predictive models were developed using histograms, and stepwise regression addressed variable collinearity. Internal validation was performed, and results were compared to similar studies. RESULTS In this study of 3711 BCLM patients, 2571 didn't have early death. Out of the 1164 who died early, 1086 had cancer-specific early death. Prognostic factors for early death, including age, race, tumor size, and lymph node involvement, were identified. A nomogram based on these factors was constructed, accurately predicting early all-cause and cancer-specific death. CONCLUSIONS Valuable insights into the prognosis of BCLM patients were provided, and important prognostic factors for early death were identified. The developed nomogram can assist clinicians in identifying high-risk patients for early death and inform treatment decisions.
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Affiliation(s)
- Shaochun Liu
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Yingxue Jia
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Jiaying Chai
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Han Ge
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Runze Huang
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Anlong Li
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Huaidong Cheng
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, China
- Shenzhen Clinical Medical School of Southern Medical University
- Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen, China
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Li JX, Li XL, Yu SY, Xu HX. Repeated ultrasound-guided percutaneous thermal ablation combined with systemic therapy achieves a stable condition in an end-stage patient with more than 10 liver metastases from breast cancer: The importance of sonazoid assisted contrast-enhanced ultrasound and fusion imaging. Clin Hemorheol Microcirc 2022; 82:85-93. [PMID: 35662111 DOI: 10.3233/ch-221413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The liver is one of the most frequent metastatic sites of breast cancer with a relatively poor prognosis. Systemic chemotherapy is an effective treatment but the efficacy is different between the subtypes of breast cancer. Percutaneous thermal ablation is considered to be a minimally invasive and effective local treatment for breast cancer liver metastases (BCLM). This case report described a patient with BCLM who adopted a strategy of systemic chemotherapy and repeated ultrasound (US) -guided percutaneous thermal ablation procedures. The survival time already reached 8 years till now with the metastases well-controlled and acceptable life quality was achieved.
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Affiliation(s)
- Jia-Xin Li
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Xiao-Long Li
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Song-Yuan Yu
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Hui-Xiong Xu
- Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.,Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China.,National Clinical Research Center for Interventional Medicine, Shanghai, China.,Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
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Chen PC, Lee YC, Su YC, Lee CH, Chen JH, Chen CY. Does hepatectomy improve outcomes of breast cancer with liver metastasis? A nationwide analysis of real-world data in Taiwan. PLoS One 2022; 17:e0266960. [PMID: 35446891 PMCID: PMC9022801 DOI: 10.1371/journal.pone.0266960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/30/2022] [Indexed: 12/02/2022] Open
Abstract
Background Liver metastases from breast cancer are associated with poor prognosis, and treatment options are usually restricted to palliative systemic therapy. The impact of liver resection on metastasis remains controversial. The aim of this study is to investigate whether liver resection can offer better survival outcomes in cases of isolated liver metastases from breast cancer. Methods We conducted a nationwide cohort study using a claims dataset from Taiwan’s National Health Insurance Research Database (NHIRD). We identified all patients with breast cancer (diagnostic code ICD-9: 174.x) from the Registry for Catastrophic Illness Patient Database (RCIPD) of the NHIRD who underwent mastectomy between January 1, 2000, and December 31, 2008. Patients with other malignancies (history, initially, or during follow-up), those with a history of metastasis prior to or at initial admission for mastectomy, and those without liver metastases were excluded. Patients with other metastases between mastectomy and liver metastasis and those who died at first admission for liver resection were also excluded. All patients were followed up until December 31, 2013, or withdraw from the database because of death. Results Data were analyzed for 1,116 patients who fulfilled the inclusion criteria (resection group: 89; non-resection group: 1,027). There were no differences in age, Charlson Comorbidity Index, or major coexisting diseases except renal disease between two groups. Kaplan–Meier analysis demonstrated that the liver resection group had significantly better overall survival (OS) than the non-resection group. (1-year: 96.6% vs. 52.3%, 2-year: 86.8% vs. 35.4%, 3-year: 72.3% vs. 25.2%, 5-year: 51.6% vs. 16.9%, respectively, p<0.001). Cox analysis revealed that the liver resection group exhibited a significant improvement in patient survival (hazard ratio [HR] = 0.321, 95% confidence interval [CI]: 0.234–0.440, p<0.001). Conclusion These findings indicate that liver resection may offer better survival benefit in patients with breast cancer who develop new liver metastases post mastectomy.
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Affiliation(s)
- Pin-Chun Chen
- Division of Colon & Rectal Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan
- Division of General Surgery, E-Da Da-Chang Hospital, Kaohsiung, Taiwan
| | - Yuan-Chi Lee
- Division of General Surgery, E-Da Da-Chang Hospital, Kaohsiung, Taiwan
- Division of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Chieh Su
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Division of Hematology-Oncology, E-Da Hospital, Kaohsiung, Taiwan
| | - Cheng-Hung Lee
- Department of General Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Jian-Han Chen
- Division of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Bariatric and Metabolism International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan
- * E-mail:
| | - Chung-Yen Chen
- Division of General Surgery, E-Da Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- Bariatric and Metabolism International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan
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Sun MS, Liu HJ, Yun YY, Yu ZH, Yang F, Liu YH, Xu L. Survival Benefit of Surgical Treatment Added Into Systemic Treatment for Isolated Breast Cancer Liver Metastases: A Systematic Review and Meta-Analysis. Front Surg 2021; 8:751906. [PMID: 34760920 PMCID: PMC8573018 DOI: 10.3389/fsurg.2021.751906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/27/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Compared with systemic treatment alone, whether surgical treatment combined with systemic treatment can improve survival outcomes of patients with isolated breast cancer liver metastases (BCLM) is still controversial. This meta-analysis was designed to evaluate the efficacy of surgical treatment for patients with isolated BCLM. Methods: A systematic search of PubMed, Embase, and Cochrane Library up to May 13, 2021 was conducted for relevant studies. The primary outcome was overall survival. The meta-analysis was performed using R software. The quality of the pooled study was assessed using the Newcastle-Ottawa scale. The publication bias was evaluated by funnel plots and Begg's and Egger's tests. Fixed- and random-effects models were applied according to heterogeneity. Results: 9 retrospective studies involving 13 cohorts (7 unmatched cohorts and 6 matched cohorts) were included in this study. The surgical cohorts had better overall survival than the systemic cohorts in the pooled analysis of all the included studies, in the subgroup analysis of liver resection, and in the subset of the matched cohorts. Conclusions: Compared with systemic treatment alone, surgical treatment combined with systemic treatment was proven to be associated with superior survival outcomes, which should be considered in selected patients with isolated BCLM.
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Affiliation(s)
- Ming-Shuai Sun
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Hong-Jin Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yong-Yang Yun
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Zheng-Heng Yu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Fan Yang
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Yin-Hua Liu
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Ling Xu
- Breast Disease Center, Peking University First Hospital, Beijing, China
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Govalan R, Lauzon M, Luu M, Ahn JC, Kosari K, Todo T, Kim IK, Noureddin M, Kuo A, Walid AS, Sundaram V, Lu SC, Roberts LR, Singal AG, Heimbach JK, Agopian VG, Nissen N, Yang JD. Comparison of Surgical Resection and Systemic Treatment for Hepatocellular Carcinoma with Vascular Invasion: National Cancer Database Analysis. Liver Cancer 2021; 10:407-418. [PMID: 34721504 PMCID: PMC8527916 DOI: 10.1159/000515554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/01/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Small studies from outside of the USA suggest excellent outcomes after surgical resection for hepatocellular carcinoma (HCC) with vascular invasion. The study aims to (1) compare overall survival after surgical resection and systemic therapy among patients with HCC and vascular invasion and (2) determine factors associated with receipt of surgical resection in a US population. METHODS HCC patients with AJCC clinical TNM stage 7th T3BN0M0 diagnosed between 2010 and 2017 from the National Cancer Database were analyzed. Cox and logistic regression analyses identified factors associated with overall survival and receipt of surgical resection. RESULTS Of 11,259 patients with T3BN0M0 HCC, 325 (2.9%) and 4,268 (37.9%) received surgical resection and systemic therapy, respectively. In multivariable analysis, surgical resection was associated with improved survival compared to systemic therapy (adjusted hazard ratio: 0.496, 95% confidence interval: 0.426-0.578) with a median survival of 21.4 and 8.1 months, respectively. Superiority of surgical resection was observed in noncirrhotic and cirrhotic subgroups and propensity score matching and inverse probability of treatment weighting adjusted analysis. Asians were more likely to receive surgical resection, whereas Charlson comorbidity ≥3, elevated alpha-fetoprotein, smaller tumor size, care in a community cancer program, and the South or West region were associated with a lower likelihood of surgical resection. CONCLUSION HCC patients with vascular invasion may benefit from surgical resection compared to systemic therapies. Demographic and clinical features of HCC patients and region and type of treating facility were associated with surgical resection versus systemic treatment.
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Affiliation(s)
- Rajalakshmi Govalan
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Marie Lauzon
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Michael Luu
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Joseph C. Ahn
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kambiz Kosari
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Tsuyoshi Todo
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Irene K. Kim
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mazen Noureddin
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Alexander Kuo
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Ayoub S. Walid
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Vinay Sundaram
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Shelly C. Lu
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Lewis R. Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Amit G. Singal
- Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas, USA,Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Julie K. Heimbach
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA,Liver Transplant Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Vatche G. Agopian
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Nicholas Nissen
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Ju Dong Yang
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA,Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA,*Ju Dong Yang,
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