THE IMPACT ON OVERALL SURVIVAL AND CLINICAL PROFILE OF METASTATIC BREAST CANCER PATIENTS WHO DEVELOPED PSEUDOCIRRHOSIS: A RETROSPECTIVE ANALYSIS

Introduction: Pseudocirrhosis (PC) is a radiological term used to describe liver abnormalities caused by chemotherapy for hepatic metastasis, especially from breast cancer and results in high mortality. OBJECTIVE This study analyzed overall survival (OS) and clinical profile of patients with metastatic breast cancer who developed PC and evaluated correlations between survival, new treatment and biochemical markers. Method This retrospective study conducted at a private service included women with liver-metastatic breast cancer who developed PC during systemic treatment between 2007 and 2019. Variables evaluated: age, histologic type, radiological alteration, presence of capsular retraction, ascites, liver disease burden, metastasis sites, prior treatment, values of albumin, transaminases, bilirubin and CA15.3, disease progression (DP) and treatment change after PC diagnosis. We estimated OS starting at the time of PC diagnosis until date of death by any cause. RESULT 27 patients were included. Median age was 51 years. 68% had Infiltrating Ductal Carcinoma and 75% had luminal/negative HER2 subtype. Most frequent radiological finding in liver was lobular contour (52%). 33% had capsular retraction, 50% ascites and 52% had more than 5 liver nodules. 40% had been submitted to at least 3 hormone therapies and 32% at least 2 chemotherapies prior to PC diagnosis. 46% had DP when PC was diagnosed and after that, 39% continued treatment, 21% discontinued treatment and 39% changed therapy. Median albumin value was 4.2/ dL; bilirubin 1.12mg/dL; CA15.3 442U/ml; aspartate/ alanine aminotransferases were 99UI/L and 45UI/L respectively. Bilirubin greater than 0.51mg/dL, ascites and bone metastasis were associated with poor prognosis. Median follow up was 19 months (95%CI 15.7-23.09) and OS was 3.25 months (95%CI 0.266.24). Survival rate for patients who did not receive new treatment after PC diagnosis was 0.19 months, who had modified treatment was 3.97 months and for those who continued prior treatment, survival rate was 15.67 months with statistical significance (p 0.001). Survival rate of patients with bilirubin greater than 0.51mg/dL was 2.92 months versus 26.87 months for those with lower bilirubin, with statistical significance (p 0.05). Conclusion: OS is low and the continuation of prior treatment presented better outcome. Bilirubin greater than 0.51mg/dL, bone metastasis and ascites were associated with poor prognosis. These findings can be good prognostic markers.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
30 October 2020