Surgical Extirpation of the Primary Tumor in Stage IV Breast Cancer: The Debate Continues

Israel, Irene; Margenthaler, Julie A.

doi:10.1016/j.jamcollsurg.2021.09.002

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Conversely, a number of retrospective (8) studies have suggested that surgical resection is correlated with a survival benefit in pMBC patients (9,10). However, selection bias (11) and other potential confounding factors (12) may have affected these results.…”

Section: Introductionmentioning

confidence: 99%

The prognostic role of surgery and a nomogram to predict the survival of stage IV breast cancer patients

Liu¹,

Wang²,

Feng³

et al. 2022

Gland Surg

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Background: Since numerous retrospective studies and prospective trials have shown divergent results, whether the surgical excision of the primary tumor results in survival benefits for de-novo stage IV breast cancer patients is inconclusive. Consequently, we need a prediction model of prognosis, judge the efficiency of breast surgery, and identify the advanced breast cancer patients who would benefit from surgery.Methods: We analyzed the data of 2,747 metastatic breast cancer patients (the surgery group) and 4,508 patients (the non-surgery group) from the Surveillance, Epidemiology, and End Results (SEER) database during 2010-2015. Propensity score matching (PSM) was used to attain a balance between the covariates of both groups. We then assessed the potential risk factors for the breast cancer-specific survival (BCSS) of patients in the non-surgery group by Cox regression and constructed a nomogram to predict BCSS. All the patients were classified into different risk groups based on the median risk score obtained from the nomogram. The hazard ratios of BCSS and overall survival (OS) of patients in the two groups were calculated.Results: After PSM, 2,288 patients severally in the two groups (the surgery group and the non-surgery group) were enrolled in the study. A nomogram incorporating 13 potential risk factors (i.e., age, race, cohabitation status, income, tumor grade, histotype, tumor size, lymph node status, molecular subtype, metastasis to brain, liver, lung, and chemotherapy) was constructed using the data of patients in the nonsurgery group. The C statistics for the internal (patients in the non-surgery group) and external (patients in the surgery group) validation of the nomogram were 0.70 [95% confidence interval (CI), 0.69-0.71] and 0.73 (95% CI, 0.72-0.74), respectively. In the low-risk group, patients in the surgery group had lower risks of breast cancer-specific mortality (BCSM) (hazard ratio =0.53; 95% CI, 0.47-0.59; P for interaction =0.014) and overall mortality (OM) (hazard ratio =0.52; 95% CI, 0.46-0.58; P for interaction =0.002) than those in the non-surgery group. Conclusions: Breast surgery might improve the survival of metastatic breast cancer patients in the lowrisk group. The established nomogram could provide a reference for clinicians in enabling personalized treatment among advanced breast cancer patients.

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Section: Introductionmentioning

confidence: 99%

The prognostic role of surgery and a nomogram to predict the survival of stage IV breast cancer patients

Liu¹,

Wang²,

Feng³

et al. 2022

Gland Surg

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A network dynamic nomogram for predicting overall survival and cancer-specific survival in patients with breast cancer liver metastases: an analysis based on the SEER database

Tian,

Wang,

2024

Discov Onc

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The liver stands out as one of the most frequent sites for distant metastasis in breast cancer cases. However, effective risk stratification tools for patients with breast cancer liver metastases (BCLM) are still lacking. We identified BCLM patients from the SEER database spanning from 2010 to 2016. After meticulously filtering out cases with incomplete data, a total of 3179 patients were enrolled and randomly divided into training and validation cohorts at a ratio of 2:1. Leveraging comprehensive patient data, we constructed a nomogram through rigorous evaluation of a Cox regression model. Validation of the nomogram was conducted using a range of statistical measures, including the concordance index (C-index), calibration curves, time-dependent receiver operating characteristic curves, and decision curve analysis (DCA). Both univariable and multivariable analyses revealed significant associations between OS and CSS in BCLM patients and 14 variables, including age, race, and tumor stage, among others. Utilizing these pertinent variables, we formulated nomograms for OS and CSS prediction. Subsequent validation involved rigorous assessment using time-dependent ROC curves, decision curve analysis, C-index evaluations, and calibration curves. Our web-based dynamic nomogram represents a valuable tool for efficiently analyzing the clinical profiles of BCLM patients, thereby aiding in informed clinical decision-making processes. Supplementary Information The online version contains supplementary material available at 10.1007/s12672-024-01719-1.

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Cryoablation as the primary treatment in a HER2 positive Stage IV breast cancer patient: 5 years term follow up case report

Matsumoto,

Sakamoto,

Machida

et al. 2024

Current Problems in Cancer: Case Reports

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Surgical Extirpation of the Primary Tumor in Stage IV Breast Cancer: The Debate Continues

Cited by 3 publications

References 5 publications

The prognostic role of surgery and a nomogram to predict the survival of stage IV breast cancer patients

The prognostic role of surgery and a nomogram to predict the survival of stage IV breast cancer patients

A network dynamic nomogram for predicting overall survival and cancer-specific survival in patients with breast cancer liver metastases: an analysis based on the SEER database

Cryoablation as the primary treatment in a HER2 positive Stage IV breast cancer patient: 5 years term follow up case report

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