Table 1. . Safety, morbidity and mortality of major and minor hepatectomy for breast cancer liver metastases.
Study | Number of patients | Median age (years) | Period | Type of resection | Postoperative morbidity | Management of postoperative complications | Postoperative mortality | Ref. |
---|---|---|---|---|---|---|---|---|
Raab et al. | 34 | 47 | 1983–1996 | – | – | – | 3% | [28] |
Selzner et al. | 17 | 48† | 1987–1999 | wr+segmentectomy – 10 | NR | NR | ARDS syndrome following BCNU chemo | [6] |
Hemihepatectomy – 5 | ||||||||
Yashimoto et al. | 25 | 51.3 | 1985–1998 | RH-4 | NR | NR | 0 | [7] |
LH – 3 | ||||||||
Extended LH– 4 | ||||||||
Left segmentectomy – 1 | ||||||||
SR– 13 | ||||||||
Pocard et al. | 52 | 47.07‡ | 1988–1997 | RH – 15 | 11.5% (6 patients) | one surgical reintervention for hemorrhagic syndrome | 0 | [15] |
LH – 5 | Four pleural effusions | |||||||
Extended LH – 4 | one ascites | |||||||
SR – 18 | one postoperative hemorrhagic syndrome | |||||||
WR – 7 | ||||||||
Maksan et al. | 9 | 44 | 1984–1998 | RH -1 | No major complication | 0 | [26] | |
LH –1 | ||||||||
Segmental resection -7 | ||||||||
Elias et al. | 54 | 49 years ± 5.2 | 1986–2001 | RH – 20 | 12.9% BL | Conservative management | 0 | [19] |
Extended RH – 7 | hematoma | |||||||
LH – 3 | ||||||||
Extended LH – 2 | ||||||||
SR – 12 | ||||||||
WR– 12 | ||||||||
Two patients underwent repeat hepatectomy | ||||||||
Ercolani et al. | 21 (out of 142 patients with NCNNM) | 54.6 ± 11.4 | 1990–2003 | 83 curative resections for the lot of 142 patients | 17 patients (20,5%) | 2 patients/83 – relaparotomy for hemoperitoneum | 0 | [14] |
MH >3 segments 41% | ||||||||
WR – 13.3% | ||||||||
SR – 45.8% | ||||||||
Vlastos et al. | 31 patients | 46 | 1991–2002 | MH >3 segments – 14 patients | NR | NR | 0 | [20] |
MiH – 17 pts | ||||||||
Adam et al. | 85 patients single center | 47 | 1984–2004 | MH >3 segments – 54 patients (64%) | 22% (19 pts) | Percutaneous drainage for 10 patients infected intraabdominal collections | 0 | [4] |
MiH – 41 patients (36%) | – BL 7% | Urgent reoperation for postoperative hemorrhage | ||||||
Intra-abdominal infected fluid collections 2 patients (2%) | ||||||||
Noninfected perihepatic collections 11 pts (13%) | ||||||||
Postoperative hemorrhage 1 patient transient hepatic insufficiency – 1 pt | ||||||||
20 patients (24% general complications) | ||||||||
Adam et al. | 460 patients/1452 (32%) | 53 range 10–87 | 1983–2004 | MH (>2 segments)-55% – for the whole lot | Local morbidity – 14% | Perioperative mortality (during the 2 months period following hepatectomy – 2.3% | [9] | |
General morbidity – 15% | ||||||||
Sakamoto et al. | 34 | 51 | 1985–2003 | Hemihepatectomies -15 patients | NR | NR | 0 | [24] |
Segmentectomies– 4 patients | ||||||||
NA – 15 | ||||||||
Lubrano et al. | 16 | 54 | 1989–2004 | MH 9 (>3 seg) | 6/16 | NR | 0 | [23] |
MiH (<3 seg) – 7 | BL-1 | |||||||
Subphrenic abscess -2 | ||||||||
Urinary tract infection – 3 | ||||||||
Thelen et al. | 39 | NR | 1988–2006 | MH 20 patients (51%) | 13% (5 patients) biliomas most frequently | NR | 0 | [25] |
MiH19 patients (49%) | ||||||||
Bockhorn et al. | 26 | 55.2 | 1998–2007 | RH – 6 patients | 30% | 2 patients (8%) required reoperation | 8% (2 patients) within 30 days PO | |
LH– 1 patient | four pleural effusion | |||||||
Left trisegmentectomy – 4 | one WI | |||||||
Left lateral resection – 4 | one deep venous thrombosis | |||||||
Sectorectomy – 11 | one subphrenic abscess | |||||||
Caralt et al. | 12 | 58.4 | 1988–2006 | MH (>3 segments) 6 (50%) | 2 patients (16.6%) – BL | Hepatico-jejunostomy for the bile duct stenosis at 7 months after LR | 0 | [16] |
Bile duct stenosis | ||||||||
Belda et al. | 12 patients resected/21 | 48 | 1998–2008 | 58.3% MH | 0 | – | 0 | [29] |
Hofmann et al. | 41 resected/50 | NR | 1999–2008 | 54% MH | 21%: | – percutaneous drainage for BL | 0 | [10] |
– noninfected perihepatic fluid collection – 1 | ||||||||
– wound complication -2 | ||||||||
– BL -3 | ||||||||
– transient liver insufficiency | ||||||||
Van Walsum multicenter study | 32 | 50 | 1991–2011 | 13 patients/32 MH | Intraoperative complications: | – one ileus | 0 | [12] |
-two iatrogenic lesions of the spleen – splenectomy | – one pneumonia | |||||||
– one patient – iatrogenic lesion of the left duct – stenting | – two patients – pleural effusion | |||||||
– one patient – abdominal abscess | ||||||||
– one patient – stenosis of the bile duct – ERC drainage | ||||||||
-1 patient – BLERC drainage | ||||||||
Abbott et al. | 86 | 50% > 50† | 1997–2010 | MH (>3 segments) in 62% of patients | NR | – | 0 | [27] |
Dittmar et al. | 34/50 | 53 | 1997–2010 | MH 23/34 patients | 12 patients (24%) | NR | 0 | [22] |
BL-3 | ||||||||
pleural effusion-6 PH-1 | ||||||||
wound dehiscence-2 | ||||||||
Kostov et al. | 42 | 58.2 | 2001–2007 | RH – 54.8% | 15 patients (35.9%) | – laparotomy for intra-abdominal bleeding – one patient | one patient died within a month -MSOF | [11] |
Extended | inal bleeding -1 | – biliary stenting and percutaneous drainage for BL 1 pt | – 60– and 90-day mortality were two patients (4.8%) each | |||||
RH – 2.4% | – BL – 1 | – drainage for WI – two patients | ||||||
Extended LH – 2.4 | – WI-2 | – percutaneous drainage for intra-abdominal collection – two patients | ||||||
Lateral hepatectomy – 9.5% | – intra-abdominal collections – two patients | – renal dyalsis for renal failure – two patients | ||||||
The rest of the patients underwent multiple segmentectomies | – hepatic insufficiency – two patients | |||||||
– renal failure – two patients | ||||||||
– pulmonary infection – five patients | ||||||||
Ehrl et al. | 30 | 52‡ | 2002–2011 | MH 37.9% | four patients (13.3%) | NR | one patient (3.3%) | [12] |
MiH 62.1% | -PH – two patients | – pulmonary embolism | ||||||
– WI – one patient | ||||||||
– urinary tract infection – one patient | ||||||||
Bacalbasa et al. | 43 resected/52 | 52 | 2002–2013 | MiH 67% | -BL – three patients | Conservative | 0 | [30] |
MH 33% | – intra-abdominal abscess – two patients, | |||||||
-urinary tract infection – one patient | ||||||||
WI – one patient |
†At the time of breast surgery.
‡At the time of primary breast diagnosis.
Major hepatectomies (>3 segments).
ARDS: Acute respiratory distress syndrome; BCNU: Carmustine; BL: Bile leaks; LH: Left hepatectomy; MiH: Minor hepatectomies; PH: Postoperative haemorrhage; PO: Postoperatively; RH: Right hepatectomy; SR: Segmental resection; WI: Wound infections; WR: Wedge resection.