Surgical Management of De Novo Stage IV Breast Cancer

Patrick, Jilma; Khan, Seema A.

doi:10.6004/jnccn.2015.0062

Cited by 21 publications

(17 citation statements)

References 38 publications

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“…Several studies have shown that advanced local surgery may improve survival in women with metastatic breast cancer [ 2 , 9 – 13 ]. Local resection of the primary tumor remains a positive prognostic factor in metastatic breast cancer even after adjustment for age, tumor burden, site of metastasis, race, type of surgery, margin status, and hormone receptor and HER2 receptor status [ 12 – 14 ]. A meta-analysis that included 28,693 patients with stage IV breast cancer found that patients who undergo surgical resection of the primary tumor have better survival than patients who do not undergo surgery [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Could local surgery improve survival in de novo stage IV breast cancer?

et al. 2018

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BackgroundResection of the primary tumor is recommended for symptom relief in de novo stage IV breast cancer. We explored whether local surgery could provide a survival benefit in these patients and attempted to characterize the population that could benefit from surgery.MethodsMetastatic Breast cancer patients (N = 313) with intact primary tumor between January 2006 and April 2013 were separated into two groups according to whether or not they had undergone surgery. The difference in characteristics between the two groups was analyzed using chi-square test, Fisher’s exact test and Mann-Whitney test. Univariable and multivariable Cox regression and stratified survival analysis were used to assess the effect of surgery on survival.ResultsOf the 313 patients, 188 (60.1%) underwent local surgery. Patients with local surgery had a 47% reduction in mortality risk vs. those with no surgery (median survival 78 months vs. 37 months; HR = 0.53; 95% CI, 0.36–0.78) after adjustment for clinical and tumor characteristics. Stratified survival analysis showed that patients with bone metastasis alone (and primary tumor ≤5 cm), soft tissue metastasis, or ≤ 3 metastasis sites benefit from surgery.ConclusionSurgical resection of the primary tumor can improve survival in selected de novo stage IV breast cancer patients.

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Section: Introductionmentioning

confidence: 99%

Could local surgery improve survival in de novo stage IV breast cancer?

et al. 2018

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“…Details of these initiatives are given in the overview by Bayne et al [3]. In breast cancer, similar trials are ongoing or have already completed patient accrual [7]. Preliminary results from a Turkish trial show that the effect of surgery is probably smaller than suggested by the results of the observational studies (ClinicalTrials.gov identifier NCT00557986).…”

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confidence: 95%

Treatment of the Primary Tumour in the Presence of Metastases: Lessons from Breast Cancer

Voogd

Verhoeven

2016

European Urology

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“…Among patients with breast cancer, 5% already have distant metastasis at initial presentation . Systemic therapy is used as the primary treatment for patients with distant metastases, as it results in improved survival and a low‐morbidity rate as compared with surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

“…However, several retrospective studies published over the past decade have suggested that primary tumor resection may result in a better oncologic outcome when used in conjunction with effective systemic therapy . A study based on the National Cancer Database revealed that stage IV patients who underwent surgical intervention at the primary site, with negative margins, demonstrated a statistically significant survival advantage …”

Section: Introductionmentioning

confidence: 99%

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

Lim¹,

Kim²,

Park³

et al. 2019

Breast J

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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.

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Surgical Management of De Novo Stage IV Breast Cancer

Cited by 21 publications

References 38 publications

Could local surgery improve survival in de novo stage IV breast cancer?

Could local surgery improve survival in de novo stage IV breast cancer?

Treatment of the Primary Tumour in the Presence of Metastases: Lessons from Breast Cancer

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

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