The Safety and Efficacy of Anticancer Therapy in Breast Cancer Patients with Liver Cirrhosis

Zhan-Yi Li,1 Yuan Teng,2 Chen-Meng Long,3 Ren-Bin Liu,4 Yu Liu4 1Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China; 2Department of Breast Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou, Guangdong, People’s Republic of China; 3Department of Breast Surgery, Liuzhou Women and Children’s Medical Center, Liuzhou, Guangxi, People’s Republic of China; 4Department of Thyroid and Breast Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of ChinaCorrespondence: Ren-Bin Liu, Department of Thyroid and Breast Surgery, The Third Affiliated Hospital, Sun Yat-sen University, 600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, People’s Republic of China, Tel +8618922102621, Fax +862085252154, Email [email protected] Yu Liu, Department of Thyroid and Breast Surgery, The Third Affiliated Hospital, Sun Yat-sen University, 600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, People’s Republic of China, Tel +8613560170809, Fax +862085252154, Email [email protected]: Special populations are not enrolled in randomized clinical trials, and their safety and efficacy of anticancer therapy are not well described. We aimed to assess the safety and efficacy of anticancer therapy in breast cancer (BC) patients with cirrhosis.Patients and methods: We performed a retrospective case-control study (1:5) to assess the adverse events (AEs) morbidity and mortality of anticancer therapy in BC patients with cirrhosis based on a review of patients’ medical records.Results: We included 26 BC patients with cirrhosis and 130 matched BC patients without cirrhosis. Postoperative morbidity was higher in the group with cirrhosis (26.9% vs 6.9%, P = 0.007) when postoperative mortality was not significance (3.8% vs 0%, P = 0.167). Liver toxicity (73.1% vs 26.9%, P < 0.001) was more frequent in the group with cirrhosis. The incidence of disruption and mortality during chemotherapy was higher in the group with cirrhosis (46.2% vs 3.1%, P < 0.001 and 15.4% vs 0%, P = 0.001, respectively). The 2-year recurrence rate and 2-year metastasis rate were higher in the group with cirrhosis (19.0% vs 3.8%, P = 0.022 and 23.8% vs 6.9%, P = 0.028). Cirrhosis was the risk factor for liver metastasis (OR: 17.326, 95% CI: 2.164– 138.707, P=0.007).Conclusion: It is safe for BC patients with compensated cirrhosis to accept surgery. But they are vulnerable to AEs, disruptions and death during chemotherapy and have poor prognosis. Multidisciplinary cooperation before therapy and closely monitoring AEs during therapy are critical. Attention should be given to optimize the prognosis of special BC patients.Keywords: breast cancer, liver cirrhosis, anticancer therapy, safety, efficacy