Economic evaluation of breast cancer screening for Chinese urban women / 中国肿瘤临床

Objective: To explore the effectiveness and cost of breast cancer screening strategy that is suitable for the current econom-ic conditions in China. Methods: We collected clinical and cost information of breast cancer screening for Chinese women based on previous screening programs conducted from February 2008 to December 2011 and collected the same information about breast can-cer cases diagnosed in hospitals at the same time. Markov models were developed to analyze the incremental cost-effectiveness ratios (ICER) for 132 breast cancer screening strategies compared to no screening for Chinese women. Results: In 2010, as compared to no screening, the most cost-effective breast cancer screening strategy was biennial screening with clinical breast examination (CBE) and breast ultrasound, in parallel, for women aged between 40 to 64. This screening strategy could save 1,394 quality-adjusted life years (QALY) per 100,000 women, and the cost of saving breast-cancer related QALY would be 91,944 RMB. Sensitivity analysis indicated that in 2016, the most cost-effective breast cancer screening strategy was biennial screening with CBE and mammography (MAM), in parallel, for women aged 40 to 64, with ICER of 159,637 RMB per QALY. Conclusions: Population-based breast cancer screening would be acceptable in the current conditions in China. As the Chinese economy and level of medical care improve, breast cancer screening would be more cost-effective.

Interpretation of guideline for breast cancer screening in Chinese women / 中国肿瘤临床

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

Construction and consideration of National Clinical Medical Research Center under the idea of transforming medicine / 中华医学科研管理杂志

Objective To explore the management of the development of medical research.Methods This paper analyzes the construction mode and experience of the National Center for Clinical Medicine Research in promoting the transformation of medical research,and discusses the cooperation mechanism,talent construction,performance evaluation and institution construction.Results Based on proposed development stage medical institutions and resources,and gradually improve the "transformation chain" management thinking.Conclusions Medical institutions should rely on basic and clin ical resources,based on the concept of medical transformation,strengthen the top design,and gradually change the management model.

Clinical characteristics and prognosis of primary cutaneous B-cell lymphoma: 26 case reports / 中华皮肤科杂志

[Objective] To assess the predilection age,clinical features,treatment and pognostic factors of primary cutaneous B-cell lymphoma (PCBCL).[Methods] A total of 31 patients with PCBCL were registered in Tianjin Cancer Central Registry from January 1970 to September 2010,and 26 patients had complete medical recortds.A retrospective analysis was conducted on the 26 patients.The following indices were analyzed,including gender,age,body sites of initial involvement,extent of cutaneous involvement,pathological subtypes,metastatic sites,treatment,survival and prognosis.Data were processed with SPSS16.0 software,survival analysis was carried out by using Kaplan-Meier method,univariate analysis of prognostic factors by Log-rank test,multivariate analysis of prognostic faetors by COX proportional hazards model,and variables were selected by Forward LR method.[Results] Clinical manifestafions were atypical in these patients.The ratio of man and women was 1:1.6.Of the 26 cases,12 were primary cutaneous follicle-center lymphoma (PCFCL),8 were primary cutaneous marginal zone lymaphoma (PCMZL),and 4 were PCLBCL,leg type.Follow-up revealed lymph node involvement in 8 patients (4 in cervical nodes and 4 in inguinal nodes),distant metastasis of organs in 3 patients ( 1 in lung and pleura,1 in bone marrow and 1 in central nervous system).Most patients received surgical treatment combined with chemotherapy or chemoradiation.The 5-year overall survival rate was 80.8％(21/26).Statistical analysis showed that the prognosis of PCBCL was associated with histological subtype,lactate dehydrogenase (LDH) level and globulin level,but unrelated to gender,age,site of initial involvement,extent of cutaneous involvement,involvement of lymph nodes and organs,presence of B symptoms,treatment strategies,number of relapses,level of β2-globulin and hemoglobin,or lymphocyte absolute value.[Conclusion]s PCBCL,as a kind of rare extra-nodal lymphoma,usually occurs with atypical clinical mainfestations in persons aged from 39 to 66 years.The 5-year overall survival rate was 80.8％ in these patients.The prognosis of PCBCL seems to be related to histological subtypes,LDH and globulin levels.

Analysis of the clinical features and prognostic factors of primary thyroid lymphoma / 白血病·淋巴瘤

Objective To investigate the clinical features and prognostic factors of primary thyroid lymphoma. Methods Records of 44 patients with pathologically confirmed primary thyroid lymphoma were reviewed. Detailed clinical and laboratory data were included in univariate analysis, and statistically significant factors in univariate analysis were then included in multivariate analysis.Results In univariate analysis, Ann Arbor stage, performance status, IPI, number of extra-lymphatic site, B symptoms, Hb, LDH and β_2-MG level, therapy model, histology type and tumor mass were found to be the prognostic factors associated with overall survival in primary thyroid lymphoma. In multivariate analysis, performance status, IPI, LDH, β_2-MG level, histology type, and tumor mass were independent prognostic factors of overall survival. Conclusion Performance status, IPI, LDH and β_2-MG level, histology type and tumor mass were demonstrated as independent prognostic factors of the overall survival in primary thyroid lymphoma.

Effect of RetroNectin on the Proliferation of CIK Cells and the Possible Mechanisms / 中国肿瘤临床

Objective: To investigate the effect of RetroNectin on CIKs cells and the related mechanisms. Methods: Peripheral blood mononuclear cells (PBMC) were collected from patients and divided into two groups: group Ⅰ and group Ⅱ. Samples in group Ⅰ were seeded into culture flask precoated with RetreNec-tin and CD3mAb to induce CIKs. While samples in group Ⅱ were seeded into common culture flask. The pro-liferation of CIKs was detected by cytometric analysis. The cytotoxic activity of CIKs was determined by LDH assays. The phenotype changes and cell cycle of CIKs were identified by flow cytometry. The apoptosis of cells was detected by Annexin V/PI. Western blot was employed to detect the level of protein Vav1. The CD49d and CD49e were blocked by anti-CD49d and anti-CD49e and the proliferation of cells was tested by cytometric analysis after the blockage. The phenotype changes of cells were identified by flow cytometry after the blockage. Results: RetroNectin enhanced the proliferation of CIKs (P<0.05). Flow cytometric analysis showed that RetroNectin significantly increased the number of CD25+ T cells (P<0.05). RN-CIK was more ac-tive than CIK in killing HCT-8 cell lines in vitro (P<0.05). RetroNectin could block the CIKs at G_1 phase (P<0.05) and resist apoptosis. There was no significant difference in the proliferation between the two groups af-ter the blockage with CD49d and CD49e (P>0.05). The expression of protein Vavl was associated with CD25+T cells. Conclusion: RetroNectin enhances the proliferation of CIKs by influencing the cell cycle, resist-ing apoptosis possibly through the site of CD49d and CD49e, and inducing T cell activation as the second sig-naling through Vav1.

Efficacy of Intraoperative Hyperthermic Peritoneal Perfusion on 60 Patients with Advanced Gastric Carcinoma / 中国肿瘤临床

Objective: To evaluate the efficacy of intraoperative hyperthermic peritoneal perfusion (CHPP) on advanced gastric carcinoma. Methods: Sixty patients with advanced gastric carcinoma were divided into the control group and the treatment group. All patients underwent radical gastrectomy and D2 node dissection. Patients in the treatment group received CHPP when surgical resection was completed. Patients in the control group underwent resection of gastric carcinoma without CHPP. Chemotherapy was administered with FOLFOX4 regimen intravenously for 12 cycles in both groups at 4 weeks after surgery. The serum Carcinoembryonic antigen (CEA) and CA19-9 were measured in patients with advanced gastric cancer before and after resection of tumor. Survival and recurrence in both groups were analyzed and compared. Results: The mean levels of the expression of CEA and CA19-9 in the peripheral blood of the 60 patients were significantly higher than the upper limits of normal (55.89±22.25μg/L vs 0～5μg/L; 125.35±61.78 U/mL vs 0～39U/mL P< 0.01). There were no significant differences in the mean levels of the expression of CEA and CA19-9 in the peripheral blood between the treatment group and the control group (54.67±22.95μg/L vs 56.09±22.15μg/L; 126.16±62.45 U/mL vs 123.35±60.88 U/mL,P>0.05). The serum CEA and CA19-9 levels were significantly decreased at 7 days after treatment in the treatment group (7.58±3.21 μg/L, 31.35±13.47 U/mL, P<0.01). The levels of these two tumor markers were decreased unremarkably at 7 days after treatment in the control group (37. 68±20.59μg/L, 98.23±36.28 U/mL, P>0.05). The serum CEA and CA19-9 levels were decreased significantly in both groups at 30 days after surgery (P<0.05). One-year survival and recurrence rates were 83.3% and 10% in the treatment group and 80% and 13.3% in the control group, with no significant differences between the two groups (P>0.05). Three-year survival and recurrence rates were 63.3% and 20% in the treatment group and 40% and 40% in the control group, with a significant difference between the two groups (P<0.05). Conclusion: Surgical resection combined with CHPP can significantly decrease the serum CEA and CA19-9 levels. Intraoperative CHPP for patients with advanced gastric carcinoma is helpful for preventing peritoneal metastasis and recurrence and can prolong survival time.

Clinical Analysis of the Effect of Rituximab in Combination with CTOP Chemotherapy on B Cell Non-Hodgkin's Malignant Lymphoma / 中国肿瘤临床

Objective: To evaluate the efficacy and toxicity of rituximab combined with cyclophosphamide, pirarubicin, vincristine, and prednisone (R-CTOP regimen) for B cell non-Hodgkin's lymphoma and to analyze the influential factors for patient response.Methods: The clinical data of patients with CD20 antigen treated with R-CTOP regimen were reviewed and the influence of sex, age, clinical stage, pathological type, and level of LDH and IPI on patient response was analyzed.Results: A total of 33 patients were evaluated for objective response.The complete response (CR) rate was 51.5%, the par-ticel response (PR) rate was 33.3%, and the overall response rate was 84.8%.For the 23 de novo patients, the CR rate was 56.5 %, the PR rate was 34.8%, and the OR rate was 91.3%.While in the 10 recurrent patients, the CR rate was 40%, the PR rate was 30%, and the OR rate was 70%.Sex, clinical stage, pathological type, and the level of LDH and IPI were not significantly related to clinical response.While patient age was related to clinical response.None of the patients died of therapy-related side effects.The most frequent adverse event was myelosuppression (Ⅲ-Ⅳ decrease of leukocyte account-ed for 32.1%).Cardiotoxicity and alopecia were mostly grade Ⅰ to grade Ⅱ.Other side effects can be tolerated after symp-tomatic treatment.Conclusion: R-CTOP regimen is a highly effective and well-toleraed therapy and should be the first choice in the treatment for B cell non-Hodgkin's lymphoma (NHL), especially for senior patients.

Clinical characteristics and prognostic analysis of primary testicular lymphoma / 中华泌尿外科杂志

Objective To discuss the clinical features and prognostic factors of primary testicular lymphoma (PTL). Methods A retrospective review was performed based on the clinical records of 33 PTL cases treated at Tianjin Medical University Cancer Hospital from June 1977 to May 2009.Drawing survival curves by Kaplan-Meier method, using Log-rank test to the univariate analysis, and multivariate analysis by COX regression model to evaluate independent prognostic factors. Results The median age of patients was 62 years at presentation(range 33-81 years). Painless testicular swelling was the initial symptom. The majority of histological subtype was B cell lymphoma, 48% of which was diffuse large B-cell non-Hodgkin's lymphoma. By postoperative chemotherapy and/or radiotherapy, 23 patients achieved complete remission and 7 achieved partial remission, with a median follow-up of 23 months (4-231 months). The 5 years and 10 years of overall survival was 39.1% and 19.5%. The effect of patients who received chemotherapy≥4 cycles and B cell lymphoma patients combination with Rituximab were better. In multivariate analysis, Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival. Conclusions Primary non-Hodgkin lymphoma should be treated with multi-modality strategies. Treatment with doxorubicin-based chemotherapy after orchiectomy should be recommended. Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival in PTL.

Study of the expression of Ki-67,p53,bcl-2 related with prognosis of patients with malignant lymphoma after the autologous hematopoietic stem cell transplantation / 白血病·淋巴瘤

Objective To evaluate the expression of bcl-2, p53, Ki-67 in malignant lymphoma (ML)and the relationship between the expression of bcl-2, Ki-67, p53 and prognosis for the patients who were given autologous hematopoietic stem cell transplantation (AHSCT). Methods The expression of bcl-2,Ki-67, p53 were measured by immunohistochemistry (IHC) on paraffin-embedded slices in 33 cases of ML who received AHSCT. Survival analysis was done by the Kaplan-Meier method and Log-Rank test.Multivariate analysis was carried out using COX proportional hazard model. Results For patients with ML who received AHSCT, the 3-year disease free survival (DFS) of bcl-2(+) group was 35.71%, while that bcl-2(-) group was 88.89 %. There was significant difference of DFS between the two groups. Meanwhile, for these patients, the 3-year DFS of Ki-67(+) and Ki-67(-) were 43.75 % and 85.71%, respectively (P ＜0.05).Multivariate analysis showed that the expression of bcl-2 and Ki-67 were the independent prognostic factors.Conclusion The expression of bcl-2 and Ki-67 were closely related with relapse after AHSCT in patients with ML. They were useful molecular makers for predicting the prognosis of patients with ML after AHSCT.

Fludarabine combined with pirarubicin chemotherapy for patients with relapsed or refractory indolent non-Hodgldn lymphoma / 白血病·淋巴瘤

Objective To evaluate the efficacy and safety of fludarabine and pirarubicin (FT) regimen in the treatment of refractory or relapsed indolent non-Hodgkin lymphoma (NHL). Methods A total of 40 patients with relapsed or refractory indolent NHL were treated with FT regimen, one cycle for 28 days, total 6 cycles. The data of indolent NHL patients treated with fludarabine, noventrene and dexamethasone (FND) regimen were collected as control. Results 40 patients were given 228 cycles chemotherapy, overall response rate was 62.5 %, median progression-free survival was more than 20 months and 2 years overall survival rate was 70.0 %. The main toxicities was leucopenia (80.0 %), but the incidence of WHO Ⅲ-Ⅳ leucopenia and pneumonia was less than that of in the control group, the rate were 12.5 % vs 29.0 % and 2.5 % vs 23.0 % respectively (P <0.05). Conclusion The efficacy of FT regimen was as good as FND regimen, but the incidence of leucopenia and pneumonia by Ⅲ-Ⅳ was lower in FT group than in FND group. So the FT regimen was an effective and safe second-line salvage regimen for relapsed or refractory indolent non-Hodgkin lymphoma.

The expression and significance of nerve growth factor and its receptors in pancreatic ductal adenocarcinoma / 中华内科杂志

Objective To investigate nerve growth factor (β-NGF) and its receptors expression in human pancreatic ductal adenocarcinoma. Methods Expression and distribution of β-NGF, tyrosine kinase A (TrKA) and P75NGFR were detected in operation tissue specimens of pancreatic ductal adenocarcinoma with immunohistochemistry and real-time PCR. Relations of β-NGF and its receptors with clinicalpathological characters, especially nerve invasion were analyzed. Results β-NGF and TrKA expression are higher in pancreatic adenocarcinoma than normal pancreas, and the differences are significant (P < 0. 01). Β-NGF and TrKA expression are associated with the differentiation grades(DG), lymphatic node metastasis, nerve invasion and surgical pathological stages. Poorer of DG and later stages, more expression of β-NGF and TrKA. Β-NGF and TrKA expression have positive correlations. Β-NGF, TrKA and P75NGFR mRNA expression have significantly increased 3.84,4. 23 and 2. 41 times than normal tissues by real-time PCR, respectively. Conclusions β-NGF and TrKA might play potential rules in carcinogenesis for pancreatic cancer,have affinity with clinicopathological characters of pancreatic cancer. Β-NGF and TrKA may have mutual effect in signal transduction leading to perineural invasion of pancreatic carcinoma.

Expression of neuropilin-1 in human pancreatic ductal carcinoma and MIA PaCa- Ⅱ cell lines / 中国医师杂志

pancreatic carcinoma by some signal transduction.

Regional Pancreaticoduodenectomy with Superior Mesenteric Artery Resection for Pancreatic Carcinoma: Report of 2 Cases / 中国肿瘤临床

Objective: To discuss the surgical treatment of carcinoma of the pancreas with superior mesenteric artery (SMA) invasion. Methods: Vascular resection and reconstruction of the portal vein and hepatic artery were performed in 2 cases. Results: The portal vein (PV), superior mesenteric vein (SMV) and superior mesenteric artery (SMA) were involved. During surgery, the invaded superior mesenteric vessels were localized. Case 1 underwent pancreaticoduodenectomy with vascular resection, SMA partial resection and reconstruction. Case 2 was submitted to total pancreatic resection with simultaneous vascular resection of spleen artery and SMA reconstruction. No perioperative mortality occurred. Conclusion: Regional pancreaticoduodenectomy with superior mesenteric artery resection is a safe and effective surgical treatment for pancreatic carcinoma.

Prognostic analysis of 61 cases of nasal type NK/T cell lymphoma / 白血病·淋巴瘤

Objective To investigate the clinical features and prognostic factors of nasal type NIGT cell lymphoma(NKTCL).Methods Records of 61 patients with pathologically confirmed nasal type NKTCL were reviewed.Detailed clinical and laboratory data were included in univariate analysis, and statistically significant factors in univariate analysis were then included in multivariate analysis.Results In univariate analysis,Ann Arbor stage,performance status,IPI,number of extra-lymphatic site,B symptoms,LDH and β-MG level.were found to be the prognostic factors associated with time to overall survival in nasal type NKTCL.In multivariate analysis, Ann Arbor stage,performance status,LDH and β2-MG level were independent prognostic factors of overall survival.Conclusion Ann Arbor stage,performance status,LDH and β2-MG level were demonstrated as independent prognostic factors of the overall survival in nasal type NKTCL.

Primary lymphoma of the spleen: clinical analysis of 23 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the best diagnostic and therapeutic method for primary lymphoma of the spleen.</p><p><b>METHODS</b>Clinicopathologic features of 23 patients treated from January 1956 to August 1999 were analyzed retrospectively.</p><p><b>RESULTS</b>All patients but one for exploration only (96%) underwent resection of the tumor. They accepted chemotherapy after operation. 23 patients were confirmed pathologically. B-cell type non-Hodgkin's lymphoma was noted in 21 patients and T-cell letion in 2. According to Ahman's staging, 9 patients belonged to stage I, 8 stage II, and 6 stage III. The 5-year survival rates were 50%, 40% and 16% respectively.</p><p><b>CONCLUSIONS</b>The diagnosis of splenic lymphoma is dependent mainly on B-ultrasound examination and CT scanning. Splenectomy combined with chemotherapy may provide optimum therapy for patients with splenic lymphoma.</p>

Diagnosis and treatment of primary gastric non-Hodgkin's lymphoma: analysis of 157 patients / 中华预防医学杂志

<p><b>OBJECTIVE</b>To seek the optimum treatment for patients with primary gastric non-Hodgkin's lymphoma and factors associated with prognosis.</p><p><b>METHODS</b>A retrospective study was conducted on 157 primary gastric non-Hodgkin's lymphoma patients who had received operation for 45 years.</p><p><b>RESULTS</b>The X-ray diagnosis rate was 39.4% before operation. The diagnosis rate by gastroscopy was 52.7%. Among the 157 patients, 32 belonged to stage I(E), 40 stage II(E), 29 stage III(E), and 56 stage IV(E). All of the patients were received chemotherapy or radiation. The 3-, 5-, 10-, 15-year survival rates were 51.1% (69/135), 42.3% (55/130), 20.7% (23/111), and 13.5% (14/104).</p><p><b>CONCLUSIONS</b>The 3-, 5-year survival rates in stage I(E) and stage II(E) were 2 to 5 times higher than those in stage III(E) and IV(E) (P < 0.01). The 3-, 5-year survival rates of primary gastric non-Hodgkin's lymphoma were 60.2% (65/108) and 50.0% (52/104) respectively. The prognosis was better than the 5-year survival rate of gastric cancer patients with D(2) lymphodenectomy (33.3%). Early diagnosis and treatment are effective to prevent complications, enhance quality of patient's life, and prolong the survival.</p>

The clinical senses of MUC1/Y gene expressing in gastrointestinal cancer and MUC1/Y modified DC inducing anti-tumor response / 中国免疫学杂志

Objective:For developing the study of MUC1/Y vaccine,constructed th eukaryotic expression vectors expressing MUC1/Y.Used it to modify the DC inducint CTL in order to treat the gastrointestinal cancers.Methods:Obtained the MCU1/Y cDNA full length cloned it into pIRES2 EGFP that expressing green fluorescence protein and pcDAN3 1+ respectively.Selected 8 cases of gastrointestinal cancer whose HLA phenotype was A2,inducing DC using rhIL 4 combined with GM CSF in vitro.Transfected DC with pcDAN3.1 MUC1/Y then co cultured DC with T cell to induce CTL (named as T pcDAN3 1 MUC1/Y).At the same time,used pIRES2 EGFP MUC1/Y to detect transfection efficiency.SW620 (HLA A2+,MUC1/Y+),the gastric cancer cell line was used as specific target cell;Lovo(HLA A2 ,MUC1/Y+)and Raji(HLA A2 ,MUC1/Y )were used as unspecific target cells.The cytolytic of specific CTL was measured by LDH releasing assay.The apoptosis of target cells were detected by ANNEXIN V FITC kit.The ability of IFN ? releasing of T cells was measured by ELISA.Results:The transfection efficiency of plasmid was about 8%.There was significant difference between the cytolytic activity of T pcDNA3 1 MUC1/Y to SW620,Lovo and Raji.The cytolytic activity was about (42 8?6 15),(27 26?1 96)% and (22 73?2 15)% respectively.Compared with T IL 2)CTL induced by PBMC stimulated of IL 2(100 U/ml)) and T pcDNA3 1(CTL induced by DC transfected by pcDNA3 1+),the cytolytic activity of T pcDNA3 1 MUC1/Y against SW620 cell line showed a significant increase.The results of ANNEXIN V-FITC experimences showed that T pcDNA3 1 MUC1/Y could induce apoptosis of specific target cell.Conclusion:The expressing of MUC1/Y mRNA has important sense in gastrointestinal cancer.Constructed eukaryotic vector pIRES2 EGFP MUC1/Y that contains full length MUC1/Y cDNA could be used to study the transfection efficiency and select the positive clone;pcDAN3 1 MYC1/Y could induce powerful CTL immunoresponse.

A study on expression of BRCA1 gene in sporadic ovarian epithelial cancer in China / 中国癌症杂志

Purpose:To explore whether expression of BRCA1 is altered during the development of sporadic ovarian epithelial cancer. To investigate the relationship between BRCA1 expression and clinical pathological parameters. Methods:The expression of mRNA and protein of BRCA1 were determined in 50 ovarian cancers, 11 benign ovarian tumors and 10 normal ovary tissues by means of RT PCR and S P immunohistochemical method. Results:BRCA1 mRNA relative expression levels were 0.6688?0.2232?0.9264?0.1398 and 1.0440?0.2182, respectively, and protein expression rates were 30.0%, 90.9%, and 100% in ovarian cancers, benign tumors and normal ovary tissues separately. The expression levels were significantly lower in ovarian cancers than that in the latter two. In addition, the level of BRCA1 expression decreased with pathological grade increasing; and also BRCA1 expression reduced, even deleted, in cancers with pelvic lymph node metastasis. Conclusions:Down regulation of BRCA1 expression at the levels of transcription and translation plays an important role in the occurrence, and progression of sporadic ovarian cancer. Reduction of BRCA1 expression is closely related to tumor pathological grade and probably implies a poor prognosis.

Surgical treatment of liver metastases of breast cancer / 中国普通外科杂志

Objective To evaluate hepatectomy for liver metastasis in breast cancer patients. Methods From May 1997 to May 2000, 18 primary breast cancer patients with metachronous liver metastases underwent hepatectomy. The clinicopathologic features and surgical results were analyzed. Results The actuarial 1,3-year survival rates after hepatic resection were 100% and 83. 3% for patients with solitary metastasis, and 90.9% and 54.5% for those with multiple foci. Conclusions Posthepatectomy long term survival was correlated with the number of foci in postmastectomy breast cancer patients suffering from heterochronous liver metastasis. Tumor size and TNM stage of breast cancer were not correlated with the survival. Aggressive surgery helps to prolong the survival.