1
|
Procházková K, Vojtíšek R, Vodička J, Horová J, Hošek P, Skála M, Šebek J, Dostál J, Přibáň V, Pivovarčíková K, Hes O, Třeška V, Moláček J. Hormone receptor conversion in metastatic breast cancer. Rep Pract Oncol Radiother 2024; 28:746-755. [PMID: 38515821 PMCID: PMC10954261 DOI: 10.5603/rpor.98730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/04/2023] [Indexed: 03/23/2024] Open
Abstract
Background/Objective Hormone receptor (HR) status is one of the key factors in determining the treatment of breast cancer. Previous studies suggested that HR status may change in metastatic tissue. However, available studies focused mainly on primary biopsies and there are only few trials comparing HR status in the primary tumour and the metastasis using material from complete resection. The aim of the study was to determine the frequency of HR alterations in metastatic breast cancer. Materials and methods The study retrospectively examines a total of 50 patients who underwent brain, lung, or liver metastasectomy for metastatic breast cancer between January 2000 and January 2019. Results HR conversion was observed in a total of 30 cases (60.0%), while HER-2/neu (human epidermal growth factor receptor 2) discrepancy surprisingly occurred only in one case (2.0%). A change in immunophenotype occurred in 28% of cases. Triple-negativity was more frequent in brain metastases (p = 0.039). Conclusions We have confirmed that HR conversion between the primary tumour and its metastases occurs in a significant number of cases, which has important implications for further treatment decisions.
Collapse
Affiliation(s)
- Kristýna Procházková
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Radovan Vojtíšek
- Department of Oncology and Radiotherapy, Charles University and University Hospital, Pilsen, Czech Republic
| | - Josef Vodička
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jana Horová
- Department of Neurology, Charles University and University Hospital, Pilsen, Czech Republic
| | - Petr Hošek
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Martin Skála
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jakub Šebek
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jiří Dostál
- Department of Neurosurgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Vladimír Přibáň
- Department of Neurosurgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Kristýna Pivovarčíková
- Department of Pathology, Charles University and University Hospital, Pilsen, Czech Republic
| | - Ondřej Hes
- Department of Pathology, Charles University and University Hospital, Pilsen, Czech Republic
| | - Vladislav Třeška
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jiří Moláček
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|