학술논문

Clinical characteristics and outcomes in patients with metastatic breast cancer and pseudocirrhosis: a single center retrospective cohort study
Document Type
Academic Journal
Source
Breast Cancer Research and Treatment. January, 2023, Vol. 197 Issue 1, p137, 12 p.
Subject
Oncology, Experimental
Cancer patients -- Care and treatment -- Patient outcomes
Metastasis -- Care and treatment -- Patient outcomes -- Complications and side effects
Liver
Breast cancer -- Care and treatment -- Complications and side effects -- Patient outcomes
Cancer -- Research
Liver cirrhosis -- Complications and side effects -- Patient outcomes -- Care and treatment
Language
English
ISSN
0167-6806
Abstract
Purpose Pseudocirrhosis is a term used to describe changes in hepatic contour that mimic cirrhosis radiographically, but lack the classic pathologic features of cirrhosis. This radiographic finding is frequently found in patients with metastatic breast cancer (MBC), but the risk factors and clinical consequences are poorly understood. Methods In this retrospective study, we identified patients with MBC and pseudocirrhosis who were treated at a single center from 2002 to 2021. We used chart extraction and radiology review to determine demographic characteristics, treatment history, imaging features, and complications of pseudocirrhosis. Results 120 patients with MBC and pseudocirrhosis were identified with the following BC subtypes: hormone receptor (HR) positive, HER2 negative (n = 99, 82.5%), HR+/HER2+ (n = 14, 11.7%), HR- /HER2+ (n = 3, 2.5%), and triple negative (TNBC; n = 4, 3.3%). All patients had liver metastases and 82.5% (n = 99) had > 15 liver lesions. Thirty-six patients (30%) presented with de novo metastatic disease. Median time from MBC diagnosis to pseudocirrhosis was 29.2 months. 50% of patients had stable or responding disease at the time of pseudocirrhosis diagnosis. Sequelae of pseudocirrhosis included radiographic ascites (n = 97, 80.8%), gastric/esophageal varices (n = 68, 56.7%), splenomegaly (n = 26, 21.7%), GI bleeding (n = 12, 10.0%), and hepatic encephalopathy (n = 11, 9.2%). Median survival was 7.9 months after pseudocirrhosis diagnosis. Radiographic ascites was associated with shorter survival compared to no radiographic ascites (42.8 vs. 76.2 months, p = < 0.001). Conclusions This is the largest case series of patients with MBC and pseudocirrhosis. Nearly all patients had HR+ MBC and extensive liver metastases. Survival was short after pseudocirrhosis and prognosis worse with radiographic ascites.
Author(s): Laura A. Huppert [sup.1], Zak Walker [sup.2], Moming Li [sup.3], Mi-Ok Kim [sup.3], Jennifer Callan [sup.1], Danielle Brandman [sup.4], Melanie Majure [sup.1], Michelle E. Melisko [sup.1], Hope S. Rugo [...]