Appraisal of disease-specific benefits of minimally invasiveness in surgery of breast cancer liver metastases

J Surg Oncol. 2019 Dec;120(7):1169-1176. doi: 10.1002/jso.25702. Epub 2019 Sep 9.

Abstract

Background: The primary endpoint of this study is to analyze short term benefit of laparoscopic approach (minimally invasive liver surgery [MILS]) over the open techniques in patients submitted to surgery for breast cancer liver metastases (BCLM) within a disease-specific perspective.

Material and methods: A group of 30 patients who underwent laparoscopic liver resection for BCLM constituted the Study group (MILS group) and was matched in a ratio of 1:2 with patients who underwent open surgery for BCLM (Open group, constituting the Control group).

Results: MILS approach resulted in a statistically significant lower blood loss (150 vs 300 mL; P < .05). The rate of postoperative complications was similar (13.3% and 16.6% in the MILS and Open groups, respectively). MILS approach was associated with a shorter length of postoperative stay (4 ± 2 days) compared with the Open group (7 ± 3 days), allowing a faster return to adjuvant treatments. Both MILS and open groups showed adequate oncological radicality, with comparable long-term results.

Conclusion: MILS approach to BCLM represents the optimal instrument to obtain an adequate disease clearance in the selected group of patients candidates to surgery: the type of procedure (minor resections for limited hepatic disease) and characteristics of patients contribute to enhance the feasibility and the benefits of the laparoscopic technique.

Keywords: breast cancer; laparoscopy; liver metastases; liver resection; outcome.

MeSH terms

  • Blood Loss, Surgical / statistics & numerical data*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Hepatectomy / mortality*
  • Humans
  • Laparoscopy / mortality*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Middle Aged
  • Minimally Invasive Surgical Procedures / mortality*
  • Postoperative Complications*
  • Prognosis
  • Prospective Studies
  • Survival Rate