Breast Cancer With Synchronous Metastases: Survival Impact of Exclusive Locoregional Radiotherapy

Scodan, Romuald Le; Stevens, Denise; Brain, Étienne; Floiras, J.-L.; Cohen-Solal, C.; Lande, B. De La; Tubiana-Hulin, M.; Yacoub, Sameh; Gutierrez, Maya; Ali, David; Gardner, M.; Moisson, P; Villette, S.; Lerebours, Florence; Munck, Jean Nicolas; Labib, A.

doi:10.1200/jco.2008.19.5396

Cited by 146 publications

(115 citation statements)

References 28 publications

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“…Patients who received locoregional treatment had a 3-year survival rate of 43.3%, whereas patients who did not receive locoregional therapy had a 3-year survival rate of 26.7% (P = 0.00002). In multivariable analysis, locoregional treatment was associated with a 30% reduction in the risk of death (HR: 0.70, 95% CI: 0.58-0.85) [21].…”

Section: Discussionmentioning

confidence: 99%

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

103

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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.

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Section: Discussionmentioning

confidence: 99%

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

103

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“…Early or intermediate end points can add predictive value, particularly in the context of cancers with a better prognosis. The pathological complete response (pCR) is the best validated end point for some solid cancers in the neoadjuvant setting, such as rectal cancer and breast cancer 42,43 ; nevertheless, this surrogate end point is not measurable in all disease sites and standardisation of histopathology procedures requires careful quality assurance.…”

Section: Clinical End Pointsmentioning

confidence: 99%

Clinical development of new drug–radiotherapy combinations

et al. 2016

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“…Na podstawie rejestrów SEER z roku 2007 stanowił on 5% wszystkich zachorowań, co przełożyło się na bezwzględ-na liczbę 12 600 chorych [1, 2]. W rejestrach europejskich odsetek ten wynosi 6% [3][4][5]. W roku 2000 w rejestrach województwa śląskiego stwierdzono 101 zachorowań na pierwotnie uogólnionego raka piersi, co stanowiło 6,8% wszystkich zachorowań [6].…”

Section: A Literature Review Of the Role Of Local Treatment In Metastunclassified

“…Kilka publikacji ocenia wpływ samodzielnej radioterapii na przeżycia chorych [3,5,35]. Badanie Le Scodana i wsp.…”

Section: Radioterapiaunclassified

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Rola leczenia miejscowego chorych na raka piersi w IV stopniu zaawansowania — przegląd piśmiennictwa

Nowicka¹,

Tarnawski²

2014

Nowotwory. Journal of Oncology

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Rak piersi w stadium pierwotnego rozsiewu odległego stanowi ok. 6% wszystkich raków piersi. Rokowanie dla tych chorych jest niekorzystne, a leczenie jest prowadzone z intencją paliatywną. Podstawą leczenia tej grupy chorych jest leczenie systemowe oparte na chemioterapii, hormonoterapii i immunoterapii. Chirurgiczne leczenie miejscowe lub radioterapia ogniska pierwotnego stosowane są głównie w celu łagodzenia objawów klinicznych towarzyszą-cych guzowi pierwotnemu. Krótkie przeżycia chorych oraz charakter paliatywny leczenia nie uzasadniały decyzji o agresywnym leczeniu miejscowym guza pierwotnego. Doniesienia z literatury ostatnich lat wykazały istotny wpływ zarówno miejscowego leczenia operacyjnego, jak i samodzielnej radioterapii na przeżycia chorych na raka piersi z synchronicznymi przerzutami. Celem pracy jest przedstawienie aktualnej wiedzy na temat roli leczenia miejscowego u chorych na raka piersi w stadium synchronicznego rozsiewu oraz próba odpowiedzi na pytanie o zasadność zmiany w podejściu do leczenia miejscowego tej grupy chorych. A literature review of the role of local treatment in metastatic breast cancer patientsEpidemiological data indicate that 6% of women are diagnosed with breast cancer with distant metastases at initial presentation. The survival for these patients is poor and the treatment is palliative. Therapy is based on systemic chemotherapy, hormonal therapy and immunotherapy. Local treatment is mainly recommended to prevent or relief symptoms but it is traditionally considered to have no impact on survival. The poor prognosis and palliative idea of therapy do not justify aggressive local treatment. Several studies indicate that local treatment of the primary tumour by both surgery and radiotherapy may improve survival for metastatic breast cancer patients. Hence maybe it is now time to reconsider the role of local therapies for this group of patients. The main objective of this review is to highlight current knowledge of local therapy of the primary tumour for breast cancer patients with synchronous distant metastases. We try to assess clinical practice in the local therapy of the primary tumour in metastatic breast cancer patients. NOWOTWORY Journal of Oncology 2014; 64, 2: 180-186 Słowa kluczowe: uogólniony rak piersi, leczenie miejscowe, leczenie operacyjne, radioterapia Key words: metastatic breast cancer, local therapy, surgery, radiotherapy Rak piersi w stadium pierwotnego rozsiewu odległego stanowi ok. 6% wszystkich raków piersi [1, 2]. Jest to heterogenna grupa chorych o różnym obrazie klinicznym, od pojedynczych ognisk przerzutów do wieloogniskowego, rozległego zajęcia narządów odległych, różniących się dynamiką. Na podstawie rejestrów SEER z roku 2007 stanowił on 5% wszystkich zachorowań, co przełożyło się na bezwzględ-na liczbę 12 600 chorych [1, 2]. W rejestrach europejskich odsetek ten wynosi 6% [3][4][5]. W roku 2000 w rejestrach województwa śląskiego stwierdzono 101 zachorowań na pierwotnie uogólnionego raka piersi, co stanowiło 6,8% wszystkich zachorowań [6].Pięcio...

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Breast Cancer With Synchronous Metastases: Survival Impact of Exclusive Locoregional Radiotherapy

Abstract: In our experience, LRT, consisting mainly of exclusive LRR, was associated with improved survival in breast cancer patients with synchronous metastases. Exclusive LRR may thus represent an active alternative to surgery.

Cited by 146 publications

References 28 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

Clinical development of new drug–radiotherapy combinations

Rola leczenia miejscowego chorych na raka piersi w IV stopniu zaawansowania — przegląd piśmiennictwa

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