Abstract 323P
Background
Pseudocirrhosis (PC) is defined by radiological abnormalities suggesting cirrhosis in patients (pts) with liver metastasis (mets), especially metastatic breast cancer (mBC). The cause of PC can be due to liver disease progression (DP), treatment toxicity or response to systemic treatment. PC is associated with high mortality.
Methods
A retrospective study was conducted at a Cancer Center with mBC pts and PC in the period 2010-2020. Age, histologic type, mets sites, radiological alterations, ascites, hepatic burden disease, prior treatments, bilirubin, AST and ALT levels, cause of PC and OS were analyzed. Kaplan-Meier method was used for survival analysis, log-rank test to compare survival curves, Cox regression to multivariable analysis and Chi-square test to compare proportions groups.
Results
44 pts were included, the median age of 55.5 years, 83.3% of luminal subtype, 54,6% with either mets outside liver. Liver lobular contour was the most frequent radiological finding (31%) and 57.7% of pts had ≥ 5 liver nodules. Median time from liver mets until PC was 33.3m and median OS from PC was 3.18m. PC was due to DP in 63.4% of cases and OS was lower compared to those without DP (2.16m vs 15.4m; hazard ratio [HR] 2.37; p < 0.03; 95% CI 1.06 to 5.27). In 31,7% of pts, PC was due to clinical response to treatment, and OS reached 15.7m vs. 2.16m for those not responding to treatment (HR 2.60; p 0.02; 95% IC 1.10 to 6.17). Only 4.9% of pts had PC due to treatment toxicity, with an OS of 1.8m. OS varied according to lines of mBC treatment, being 15.8m for those with ≤ 1 prior endocrine therapy vs 8.1m for those who used ≥ 2 lines (HR 2.39; p 0.03; 95% IC 1.08 to 5.25) and 22.12m in patients ≥ 1 line of chemotherapy (CT) vs. 6.46m for ≥ 2 CT lines (HR 3.34; p < 0.01; 95% IC 1.36 to 8.17). AST levels ≥ 2 times the upper limit correlated with a worse outcome (OS of 2.16m vs. 15.24m. HR 2.90; p 0.01; 95% IC 1.19 to 7.05), also observed with ALT levels - OS 1.87m vs. 3.97m (HR 2.38; p 0.03; 95% IC 1.04 to 5.46) and abnormal values of bilirubin (1.77m vs. 15.24m; HR 4.18; p < 0.01; 95% IC 1.80 to 9.69).
Conclusions
This is one of the largest series of PC in mBC. PC overall survival is low, varies according to its cause and some markers would indicate a worse outcome. These parameters should be strongly valued in PC pts.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.