Effect of primary tumor resection on overall survival in patients with stage IV breast cancer

Abstract

We aimed to evaluate the effect of primary tumor resection on overall survival in stage IV breast cancer patients. In total, 284 breast cancer patients presenting with breast cancer at stage IV at initial diagnosis, between 2001 and 2014, were enrolled in the study. Patients were divided into two groups based on surgical resection of the primary tumor. Overall survival (OS) between the two groups was analyzed. Patients in the surgery group (n = 92) had smaller tumors than those in the no‐surgery group (n = 192, T0‐1:17.7% vs 34.8%, P < 0.001). The surgery group more often had negative nodal status (5.7% vs 33.7%, P < 0.001). Multiple metastatic organ sites were more common in the no‐surgery group than in the surgery group (55.7% vs 15.2%, P < 0.001). The surgery group showed a better OS than the no‐surgery group (P = 0.01). Multivariate analysis showed that surgical resection of primary tumors tended to be associated with improved OS (HR = 0.67, P = 0.055). T stage, ER, HER2 and metastatic organ sites were independent prognostic factors for OS in multivariate analysis. Surgical resection of the primary tumor may be a treatment option for patients with stage IV disease and may not have a negative effect on overall survival.

Development of an Individualized Prediction Calculator for the Benefit of Postoperative Radiotherapy in Patients with Surgically Resected De Novo Stage IV Breast Cancer

“…LRT can consist of surgery alone, RT alone, or both. Several retrospective series have reported an association between LRT and improved survival in patients with stage IV breast cancer at the time of diagnosis [ 9 , 10 , 11 , 12 , 13 , 14 ]. A meta-analysis including 28,693 patients found that surgical excision of the primary breast lesion improved the three-year survival from 22% to 40% ( p < 0.01) [ 15 ].…”

Could Primary Tumor Resection Improve Survival in Metastatic Breast Cancer?

“…In addition, a Korean study shows that, curiously, in a 5-year overall survival rate of 49% and 29.8% for surgery and no surgery, respectively, regarding tumor subtype, the luminal B had significantly better overall survival with surgery (OS rate = 63.9%, p =0.03) [15]. The reason for these results is not clear, but is hopeful considering the current prognosis for these patients and is something to be investigated in future studies.…”

Early Death Incidence and Prediction in Stage IV Breast Cancer

“…As with all retrospective reviews, there was a possible patient selection bias contributing to the better results in the patients after surgery [ 9 ]. Patients with better conditions and less risk were reported to be more likely to receive surgical interventions [ 7 ]. Therefore, the actual benefit from surgery for stage IV breast cancer should be evaluated.…”

“…As to the United States, approximately 5% of women with newly diagnosed breast cancer were reported to present with stage IV at diagnosis [ 7 ]. The proportion of stage IV breast cancer was even higher in the Asian population [ 8 ].…”