Breast cancer liver metastases in a UK tertiary centre: outcomes following referral to tumour board meeting

Introduction To assess the outcomes from multidisciplinary board meetings (MDM) for patients with breast cancer liver metastases (BCLM) and identify prognostic factors for survival. Materials and Methods A retrospective review of MDM records for patients referred with BCLM to a tertiary centre between 2005-2016. Patient demographics, clinicopathological factors and intervention type were analysed to find predictive factors for overall survival. Results 61 patients with BCLM were referred to the MDM. Treatment pathways included surgical resection (n=23), radiofrequency ablation (RFA, n=11), or chemotherapy (n=27). Surgical resection patients had an improved median overall survival compared to chemotherapy (49 v 20mo; p<0.001). RFA showed comparable survival benefit (37 v 20mo; p=0.011). Resection and RFA showed no significant difference in survival over one another (49 v 37mo; p=0.854). Survival analysis identified that resection (p=0.002) and RFA (p=0.001) were associated with improved overall survival compared to chemotherapy. Multivariate analysis identified extrahepatic disease (HR=14.21; p=0.044) and R0 resection (HR=0.068; p=0.023) as prognostic factors. Conclusions Surgical resection of BCLM may improve the overall survival in selected patient groups. This study identifies a cohort of patients, without extrahepatic disease and responsive to chemotherapy, who may particularly benefit from surgery.