Letters To The Editor
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2005; 11(44): 7057-7057
Published online Nov 28, 2005. doi: 10.3748/wjg.v11.i44.7057
Hormone receptor status of primary tumor as a prognostic factor in patients with liver metastases from breast cancer treated with transcatheter arterial chemoembolization
Kadri Altundag, Ozden Altundag, Serdal Aktolga, Ozlem Yavas, Cem Boruban
Kadri Altundag, Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
Ozden Altundag, 8181 Fannin Street No. 728 Houston, Texas, United States
Serdal Aktolga, Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey
Ozlem Yavas, Cem Boruban, Department of Medical Oncology, Selcuk University Faculty of Medicine, Konya, Turkey
Author contributions: All authors contributed equally to the work.
Correspondence to: Kadri Altundag, 8181 Fannin Street No. 728, Houston, Texas 77054, United States. altundag@sbcglobal.net
Telephone: +1-713-563-0909 Fax: +1-713-794-4385
Received: June 27, 2005
Revised: July 17, 2005
Accepted: July 20, 2005
Published online: November 28, 2005



We read with great interest the article by XP et al[1] They reported the results of their experience with transcatheter arterial chemoembolization (TACE) and systemic chemotherapy for forty-five patients with liver metastases from breast cancer and evaluate the prognostic factors. In their study, the response and survival rates were significantly better in TACE group than in chemotherapy group. The lymph node status of the primary cancer, the clinical stage of liver metastases, the Child-Pugh grade, loss of weight were found to be significantly associated with survival in both univariate and multivariate and analyses. However, they did not mention hormone receptor status of the patients that might have an effect on the survival rate. Elias et al[2] in their study evaluated 54 breast cancer patients with liver metastases as the sole site of metastatic disease (except for bone metastases in 3 patients) that underwent hepatectomy. They showed that the only factor influencing survival in both the univariate and multivariate analyses was the hormone receptor status (P = 0.03), and the relative risk of death increased by 3.5-fold when hormone receptor was negative. Moreover, Mack et al[3] reported excellent local tumor control and survival rates achieved by laser induced interstitial thermotherapy (LITT) in breast cancer patients with liver metastases. Regarding the prognostic and predictive factors related to primary tumor, they found no statistically significant difference in terms of mean survival between the patients with N0-N1 lymph nodes and N2-N3 lymph nodes. However, they found that the hormone receptor status is a significant (P<0.05) prognostic factor on both mean and median survival. The mean survival in patients with positive hormone receptor status was 5.5 years (95%CI: 4.8-6.3 years, median survival 4.7 years) starting the calculation at the date of diagnosis of the metastases treated with LITT. The mean survival in patients with negative hormone receptor status was 3.7 years (95%CI: 2.8-4.6 years, median survival 5.1 years)[4].

In the light of the above information, hormone receptor status of primary tumor should also be evaluated as a prognostic factor in patients with breast cancer and liver metastases treated with TACE and systemic chemotherapy.


Science Editor Guo SY Language Editor Elsevier HK

1.  Li XP, Meng ZQ, Guo WJ, Li J. Treatment for liver metastases from breast cancer: results and prognostic factors. World J Gastroenterol. 2005;11:3782-3787.  [PubMed]  [DOI]
2.  Elias D, Maisonnette F, Druet-Cabanac M, Ouellet JF, Guinebretiere JM, Spielmann M, Delaloge S. An attempt to clarify indications for hepatectomy for liver metastases from breast cancer. Am J Surg. 2003;185:158-164.  [PubMed]  [DOI]
3.  Mack MG, Straub R, Eichler K, Söllner O, Lehnert T, Vogl TJ. Breast cancer metastases in liver: laser-induced interstitial thermotherapy--local tumor control rate and survival data. Radiology. 2004;233:400-409.  [PubMed]  [DOI]
4.  Altundag K, Altundag O, Morandi P, Gunduz M. Hormone receptor status in patients with breast cancer and liver metastases treated with laser-induced intersititial thermotherapy. Radiology. 2005;235:339; author reply 339-340.  [PubMed]  [DOI]