Matched Pair Analyses of Stage IV Breast Cancer with or Without Resection of Primary Breast Site

Cady, Blake; Nathan, Neera; Michaelson, James; Golshan, Mehra; Smith, Barbara L.

doi:10.1245/s10434-008-0085-x

Cited by 146 publications

(107 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Separate discussion on 'negative' studies Three studies did not find a positive effect of surgery on overall survival in patients with primary metastatic breast cancer [14][15][16].…”

Section: Resultsmentioning

confidence: 99%

“…In the largest 'negative' study, it was suggested that case selection bias and coding errors may explain an important part of the survival advantage observed in stage-IV breast cancer patients undergoing surgery [16]. The investigators used case-matching, according to age, year of diagnosis, site of metastatic disease, hormone receptor status, and use of systemic therapy, to make patients with and without surgery more comparable and to remove bias by these factors.…”

Section: Resultsmentioning

confidence: 99%

“…However, recent studies suggest that breast surgery has a favorable impact on the prognosis of patients with primary metastatic breast cancer, and that it may be time to reconsider the treatment paradigm ''no surgery of the primary tumor'' [7][8][9][10][11][12][13]. On the other hand, not all studies addressing this subject have reported a better prognosis for the patients undergoing surgery [14][15][16], and the investigators of these studies suggest that the beneficial effect seen in other studies may be the result of selection bias.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of breast surgery on survival in patients with distant metastases at initial presentation: a systematic review of the literature

Ruiterkamp

Voogd

Bosscha

et al. 2009

Breast Cancer Res Treat

104

View full text Add to dashboard Cite

According to current treatment standards, patients with metastatic breast cancer at diagnosis receive palliative therapy. Local treatment of the breast is only recommended if the primary tumor is symptomatic. Recent studies suggest that surgical removal of the primary tumor has a favorable impact on the prognosis of patients with primary metastatic breast cancer. We performed a systematic review of the literature to weigh the evidence for and against breast surgery in this patient group. Ten retrospective studies were found in which the use of breast surgery in primary metastatic breast cancer and its impact on survival was examined. The hazard ratios of the studies were pooled to provide an estimate of the overall effect of surgery, and the results and conclusions of the studies were analyzed. A crude analysis, without adjustment for potential confounders, showed that surgical removal of the breast lesion in stage-IV disease was associated with a significantly higher overall survival rate in seven of the ten studies, and a trend toward a better survival in the three remaining studies. Surgery of the primary tumor appeared to be an independent factor for an improved survival in the multivariate analyses from the individual studies, with hazard ratios ranging from 0.47 to 0.71. The pooled hazard ratio for overall mortality was 0.65 (95% CI 0.59-0.72) in favor of the patients undergoing surgery. This systematic review of the literature suggests that surgery of the primary breast tumor in patients with stage-IV disease at initial presentation does have a positive impact on survival. In order to provide a definite answer on whether local tumor control in patients with primary metastatic disease improves survival, a randomized controlled trial comparing systemic therapy with and without breast surgery is needed.

show abstract

“…Separate discussion on 'negative' studies Three studies did not find a positive effect of surgery on overall survival in patients with primary metastatic breast cancer [14][15][16].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of breast surgery on survival in patients with distant metastases at initial presentation: a systematic review of the literature

Ruiterkamp

Voogd

Bosscha

et al. 2009

Breast Cancer Res Treat

104

View full text Add to dashboard Cite

show abstract

“…Other researchers have investigated additional confounding factors and they concluded that the survival benefit, seen in patients who were treated with a surgical resection of the primary tumor, was not as strong as reported previously or could be fully explained by these additional confounders. [8][9][10] For instance, in one of these studies the authors concluded that the benefit of surgery is confined to patients operated upon before diagnosis of metastatic disease, as there was no survival advantage in patients who received an operation of the breast tumor after the diagnosis of the metastatic disease had taken place. [9] So far, most studies have been performed with data from population-based or hospital-based cancer registries, which lack information on the timing of surgery or other potential confounders and which might suffer from missing values or coding errors.…”

Section: Introductionmentioning

confidence: 99%

Presence of symptoms and timing of surgery do not affect the prognosis of patients with primary metastatic breast cancer

Ruiterkamp

Voogd

Bosscha

et al. 2011

European Journal of Surgical Oncology (EJSO)

View full text Add to dashboard Cite

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPTThere are no financial disclosures or conflicts of interest from any of the authors.This work had no specific funding.No acknowledgements. Keywords:Breast neoplasms -Neoplasm metastasis -Surgery -Confounding Factors -Aims Though most studies on surgical resection of the breast tumor in patients with primary distant metastatic breast cancer (MBC) indicated that surgery is associated with prolonged overall survival, some state that this effect has been confounded by indication and timing of surgery. In this study we analysed these possible confounders and their relation to overall survival. MethodsTo determine the impact of potential confounders, individual charts of 279 patients with primary MBC were reviewed. ResultsThe median survival in patients treated with surgery of the breast tumor was 39 months, compared to 15 months for those without surgery (p<0.0001).The median survival of patients with symptomatic metastatic disease (n=112) was 19 months, compared to 22 months for those without symptomatic disease (n=167) (p=0.15). Patients who received surgery and whose metastases were detected before surgery of the breast tumor had taken place (n=40) had a median survival of 38 months, compared to 40 months for patients in whom the metastatic disease was diagnosed after surgery (n=43) (p=0.81). ConclusionPresence of symptomatic metastatic disease was no significant prognostic factor for patients with distant metastasis at diagnosis, neither was the timing of surgery. It is unlikely that the prolonged survival after surgery is explained by these potentials confounders.

show abstract

“…Диагностика Оригинальные статьи к проблеме контроля первичной опухоли при ПРРМЖ [4,6,[14][15][16][17][18][19][20][21][22][23][24]. Существует несколько патофизиологических обоснований целесообразности удаления первичной опухоли при ПРРМЖ.…”

Section: опухоли женской репродуктивной системы Tumors Of Female Reprunclassified

Evaluation of the scientific results of the study entitled “Opportunities for surgical treatment of patients with stage IV breast cancer” performed by Russian Society of Oncomammologists (RSOM)

Bozhok¹,

Топузов²,

Зикиряходжаев³

et al. 2016

Tumors of female reproductive system

View full text Add to dashboard Cite

ОПУХОЛИ ЖЕНСКОЙ РЕПРОДУКТИВНОЙ СИСТЕМЫ TUMORS OF FEMALE REPRODUCTIVE SYSTEM Russia; 3 2nd Botkinskiy Proezd, Moscow 125284, Russia; 5 N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia; 23 Kashirskoe Shosse, Moscow 115478, Russia; 6 Rostov Research Institute of Oncology, Ministry of Health of Russia; 63 14th Liniya St., Rostov-on-Don 344037, Russia; 7 N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia; 68, Leningradskaya St., Pesochnyi Settlement, Saint Petersburg 197758, Russia

show abstract

Matched Pair Analyses of Stage IV Breast Cancer with or Without Resection of Primary Breast Site

Cited by 146 publications

References 34 publications

Impact of breast surgery on survival in patients with distant metastases at initial presentation: a systematic review of the literature

Impact of breast surgery on survival in patients with distant metastases at initial presentation: a systematic review of the literature

Presence of symptoms and timing of surgery do not affect the prognosis of patients with primary metastatic breast cancer

Evaluation of the scientific results of the study entitled “Opportunities for surgical treatment of patients with stage IV breast cancer” performed by Russian Society of Oncomammologists (RSOM)

Contact Info

Product

Resources

About