Locoregional surgery of the primary tumor in stage IV breast cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 566-566
Author(s):  
Ying Wang ◽  
Yunfang Yu ◽  
Kai Chen ◽  
Tuping Fu ◽  
Herui Yao
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Primary Tumour ◽  
Stage Iv ◽  
Current Evidence ◽  
Breast Cancer Patients ◽  
Stage Iv Breast Cancer ◽  
Significant Difference ◽  
Quality Evidence

566 Background: Existing guidelines lack clear recommendations for the role of locoregional treatment for the primary tumor in women with stage IV breast cancer. We aimed to compare the effectiveness of locoregional surgery with no surgery of the primary tumour in stage IV breast cancer patients. Methods: Eligible studies were randomized clinical trials (RCTs) that investigated the effect of locoregional surgery versus no surgery of the primary tumour in stage IV breast cancer patients. The primary outcome was overall survival (OS), measured as hazard ratios (HRs). Secondly outcomes included 2-year and 3-year OS, expressed as odds ratios (ORs). Meta-analyses and trial sequential analysis (TSA) were conducted. Quality was evaluated using the GRADE. Results: Data were included from four RCTs involving 767 participants, including 377 who underwent locoregional surgery and 390 who with no surgery. The median follow-up was 28.6 months (95% confidence interval (CI) 24.1 to 33.9). In a meta-analysis of these trials, the low-quality evidence indicated that locoregional surgery versus no surgery did not significantly affect OS (HR = 0.87, 95% CI 0.59 to 1.29, P = 0.490), 2-year OS (OR = 1.23, 0.66 to 2.30, P = 0.510), or 3-year OS (OR = 1.08, 0.94 to 1.25, P = 0.263). TSA showed that more trials were needed before reliable conclusions could be drawn regarding in both 2-year and 3-year OS. Across the subgroup analysis of OS, we found the moderate-quality evidence that locoregional surgery followed by chemotherapy versus chemotherapy alone resulted into a significantly improved survival (HR = 0.65, 95% CI 0.49–0.87, P = 0.004); but no statistically significant difference was identified in term of response to chemotherapy with or without locoregional surgery (HR = 1.06, 95% CI 0.83–1.36, P = 0.632). Conclusions: The current evidence suggests that locoregional surgery followed by chemotherapy, compared with chemotherapy alone, was beneficial for prolonging OS in patients with stage IV breast cancer, but surgery did not impact OS among patients who have responded to chemotherapy.

The Impact of Primary Tumor Surgery on Survival in HER2 Positive Stage IV Breast Cancer Patients in the Current Era of Targeted Therapy

2020 ◽  
Vol 27 (8) ◽  
pp. 2711-2720 ◽  
Author(s):  
Ross Mudgway ◽  
Carlos Chavez de Paz Villanueva ◽  
Ann C. Lin ◽  
Maheswari Senthil ◽  
Carlos A. Garberoglio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapy ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Stage Iv ◽  
Tumor Surgery ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Stage Iv Breast Cancer ◽  
The Impact

Impact on overall survival of primary tumor extirpation in breast cancer patients who present with stage IV disease

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 598-598
Author(s):  
J. E. Lang ◽  
R. Rao ◽  
L. Feng ◽  
F. Meric-Bernstam ◽  
I. Bedrosian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Survival Benefit ◽  
Stage Iv ◽  
Breast Cancer Patients ◽  
Stage Iv Breast Cancer ◽  
Stage Iv Disease

598 Background: Limited data exists regarding optimal local therapy for patients who present with stage IV breast cancer with an intact primary tumor. Two retrospective series, from the National Cancer Data Base and the Geneva Cancer Registry, showed that surgery may improve overall survival in these patients. Our institutional experience demonstrated improved metastatic progression-free survival after a median follow-up of 32.1 months but did not show a survival benefit at short term follow-up. We evaluated the impact of local control on overall (OS) and disease-specific survival (DSS) in this population after a longer follow-up interval to determine if a survival benefit could be demonstrated from local surgical treatment for selected patients with stage IV breast cancer. Methods: We reviewed the records of all patients at our institution who presented from 1997–2002 with stage IV disease with an intact primary tumor. OS and DSS were estimated by the Kaplan-Meier method. The log-rank test was used to compare the difference in survival between surgical and non-surgical patients. Multivariate statistical analysis was performed using the Cox proportional hazards model. Results: Of 220 patients identified with stage IV disease with an intact primary tumor, 80 (36%) underwent surgical resection of the primary tumor; 39 (49%) had segmental mastectomy and 41 (51%) had a total mastectomy. There were 140 (64%) patients who did not undergo surgery. The median follow-up duration from time of presentation to our institution was 58.6 months and the median OS time after presentation was 45.8 months. After adjustment for covariates, surgery was associated with improved OS (p=0.03) and DSS (p=0.04) compared to the non-surgical group. Conclusions: With a median follow-up time of 58.6 months, patients who presented with stage IV breast cancer with an intact primary tumor treated surgically had significantly improved OS and DSS compared to patients who did not undergo surgery. Our findings may be limited by a selection bias. Therefore, we feel that the issue of surgical intervention for the primary tumor in stage IV breast cancer patients deserves to be carefully studied in a well-designed, prospective, multi-center trial. No significant financial relationships to disclose.

Local treatment of breast in de novo stage IV breast cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11526-e11526
Author(s):  
Peng-Yu Chen ◽  
Skye H Hong-Chun Cheng
Keyword(s):  
Breast Cancer ◽  
Liver Metastasis ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Primary Breast Cancer ◽  
De Novo ◽  
Local Treatment ◽  
Stage Iv ◽  
Breast Cancer Patients ◽  
Stage Iv Breast Cancer

e11526 Background: Stage IV breast cancer is an incurable disease. Systemic therapy is usually the main treatment for these patients. Locoregional therapy, such as surgery or radiotherapy, is controversial. Recent studies suggested locoregional treatments of the primary breast cancer can provide some benefit for these patients. Methods: We conducted a chart review of de novo stage IV breast cancer patients at a cancer center hospital in TAIWAN from 1990 to 2008. A total of 276 patients were reviewed and 268 patients met the inclusion criteria. Tumor characteristics, anti-tumor treatments and survival were analyzed. Results: The median survival of 268 patients was 21.5 months. We divided these patients into two groups. There were 140 patients with less than 21.5 months of survival and 128 patients with more than 21.5 months of survival. In univariate analysis, infiltrating ductal carcinoma (p=0.002), ER-positive (p<0.0001), PR-positive (p<0.0001), and no overexpression of HER2 (p=0.0125) were associated with longer survival. The clinical primary tumor size (p=0.11) and positive axillary lymph node involvement (p=0.61) were not different significantly between two groups. About metastatic site, patients with liver mets (p<0.0001) and lung mets (p=0.025) were associated with shorter survival. Bone mets (p=0.63) was not associated with survival. Patients receiving local treatment of primary tumor, including surgery (p<0.0001) or locoregional radiation (p=0.0034), had longer survival. In multivariate analysis, patients who received surgery of primary breast cancer (HR=0.52, p=0.0006) or received systemic chemotherapy (HR=0.47, p=0.002) had better survival. In subgroup analysis, patients without liver metastasis who received surgery of primary breast cancer had longer overall survival significantly (p<0.0001). In contrast, surgery to the primary breast cancer had no benefit in survival (p=0.91) in patients with liver metastasis. Conclusions: Our institutional experience suggests locoregional treatment for primary breast cancer appear to be beneficial for de novo breast cancer patients, especially those without liver mets.

Primary tumor resection in de novo stage IV breast cancer patients

2020 ◽  
Vol 26 (7) ◽  
pp. 1366-1369
Author(s):  
Craig Joshua Follette ◽  
Clare Humphrey ◽  
Amanda Amin ◽  
Christa Balanoff ◽  
Jamie Wagner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Primary Tumor ◽  
De Novo ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Breast Cancer Patients ◽  
Stage Iv Breast Cancer
Sign in / Sign up

Export Citation Format

Share Document