The Clinical Features and Outcomes of Pseudocirrhosis in Breast Cancer

Author:

Phillips Edward1,Sethi Mantegh2,Vasanthakumar Surammiya1,Sherpa Gina1,Johnston Stephen1,Parton Marina1,Kipps Emma1ORCID,Turner Nicholas C.1,Foxton Matthew13,Okines Alicia1ORCID

Affiliation:

1. Breast Unit, The Royal Marsden Hospital, London SW3 6JJ, UK

2. Department of Surgery, University Hospitals Birmingham, Birmingham B15 2GW, UK

3. Department of Gastroenterology, Chelsea and Westminster Hospital, London SW10 9NH, UK

Abstract

Pseudocirrhosis is a diffuse nodularity of the liver that radiologically mimics cirrhosis but is a distinct pathological process. It is seen almost exclusively in patients with liver metastases and may represent a response to systemic treatment. Data on the risk factors for pseudocirrhosis and outcomes are limited. In total, 170 patients with a diagnosis of breast cancer and pseudocirrhosis in a 10-year period were identified and retrospectively analysed. Data were collected on baseline patient characteristics, treatments received, and outcomes. Median time between diagnosis of liver metastases and diagnosis of pseudocirrhosis was 17.1 months (range, 0–149 months). In total, 89.4% of patients received chemotherapy between their diagnosis of breast cancer liver metastases and their diagnosis of pseudocirrhosis, most commonly a taxane (74.7%) or capecitabine (67.1%), and the median treatment lines received was 3. Median OS from first diagnosis of pseudocirrhosis was 7.6 months (95% CI: 6.1–9.6 months) and was longer in patients with HER2+ disease at 16.7 months (95% CI: 6.4–32.9 months), which was statistically significant. In our study, pseudocirrhosis occurred in the presence of liver metastases and was associated with a poor prognosis. HER2+ patients with pseudocirrhosis had a better prognosis than other subtypes, but we did not identify other significant predictors of survival. Chemotherapy was not a prerequisite for pseudocirrhosis development, although the majority of patients had received at least one line of chemotherapy before pseudocirrhosis was diagnosed.

Publisher

MDPI AG

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