Clinical features and prognostic factors for extracranial oligometastatic breast cancer in China

Abstract

Evidence of an oligometastatic state in metastatic breast cancer (MBC) is relatively limited. The aim of our study was to investigate the clinical features and prognostic factors for extracranial oligometastatic breast cancer and to identify the best treatment approaches in this select population. Fifty postoperative inpatients diagnosed with extracranial oligometastatic breast cancer at the National Cancer Center in China between 2009 and 2014 were consecutively enrolled. Oligometastatic breast cancer was defined as MBC with three or fewer metastatic lesions confined to one organ; de novo Stage IV disease and local-regional recurrence were excluded. The median progression-free survival (PFS) and overall survival (OS) times were 15.2 and 78.9 months, respectively, and the 2-year PFS and 5-year OS rates were 40% and 58%, respectively. First-line treatment approach with standard systemic treatment + surgical resection for all metastatic lesions was an independent prognostic factor for prolonged PFS (hazard ratio = 0.32; 95% confidence interval [CI], 0.14-0.73; P = .006) and OS (hazard ratio = 0.35; 95% CI, 0.14-0.86; P = .022). Subgroup analysis showed that patients with a disease-free interval (DFI) ≥24 months, one metastatic lesion or the hormone receptor (HR) + subtype were more likely to get benefit from resection. Patients with oligometastatic breast cancer have a relatively good prognosis. Surgical resection for metastatic lesions could significantly improve PFS and OS. Further prospective research is warranted to confirm the results and to develop biomarkers for better patient selection.

Systemic Therapy Combined with Locoregional Therapy Improved Survival in Oligometastatic Breast Cancer: A Single-Center Retrospective Cohort Study

“…The innovation of our study was that we also explored whether the sequence of systemic therapy and locoregional therapy could affect survival. We found that there was no significant difference between the ST to LRT group and the LRT to ST group, similar to the study of Lan et al, which noted that among patients treated with surgical resection, there was no difference in PFS between patients having resection first and those having systemic therapy first (P = 0:807) [5]. However, Cha et al argued that systemic therapy should be made after or at the same time as local therapy to control the residual Abbreviations: ST to LRT: systemic therapy followed by locoregional therapy; LRT to ST: locoregional therapy followed by systemic therapy; ST: systemic therapy.…”

“…Finally, 20 patients received systemic treatment and surgical resection, 10 patients received systemic treatment and local treatment other than resection, and 20 patients received systemic treatment alone. The median PFS was 49.6 months, 13.8 months, and 6.9 months, respectively, and the 2-year PFS rate was 65%, 30%, and 20%, respectively [ 5 ]. Concerning patients with HR-positive and HER2-negative OMBC, Cha et al found that the median PFS was significantly longer in patients with local treatment than in patients without local treatment (30.0 vs. 18.0 months, P = 0.049) [ 12 ].…”

“…Previous studies have suggested that OMBC might benefit from locoregional therapy [5][6][7][8]. However, whether such benefit seen in those studies resulted from the efficacy of locoregional treatment itself or selection bias due to the favorable inclusion criteria remained controversial [9].…”

Breast cancer patients with isolated bone metastases and oligometastatic bone disease show different survival outcomes

“…In addition, in a systematic review examining prognostic factors on survival in patients with oligometastatic breast cancer, solitary metastasis was associated with better OS 8 . In a study of 50 patients with extracranial oligometastatic breast cancer, those with single metastasis highly benefited from systemic chemotherapy and surgical resection and gained survival advantage with statistical significance 16 .…”

Solitary Bone Metastasis and Oligometastatic Bone Disease in Breast Cancer: Are They Two Different Entities?

“…This result indicates that BC patients with OMBD do not have . Indeed, in a study of fty patients with extracranial oligometastatic breast cancer, those with single metastasis were highly bene ted from systemic chemotherapy and surgical resection and gained survival advantage with statistical signi cance [17].…”