Local treatment in oligometastasis from breast cancer: an overview

Burgaleta, A. Manterola; Burguete, Andrea Barco; Gutiérrez, Lombardo Rosas; Nuín, Erkuden Burillo; Felipe, G. Asín; Vega, F. Arias de la

doi:10.1007/s12094-023-03170-0

Cited by 3 publications

(4 citation statements)

References 34 publications

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“…Currently, there is no compelling prospective evidence supporting surgery or radiation to distant metastatic sites in TNBC management. The SABR COMET study showed an OS advantage with stereotactic radiation in oligometastatic cancer (only 18 out of the 99 patients had breast cancer), but the NRG BR-00213 study carried out exclusively in breast cancer patients showed no OS benefit [38]. Similarly, randomized controlled data for surgery of the primary tumor have not demonstrated an OS benefit, and there are no randomized trials examining surgery of the distant metastatic sites [39].…”

Section: Discussionmentioning

confidence: 99%

Overall Survival and Prognostic Factors in Metastatic Triple-Negative Breast Cancer: A National Cancer Database Analysis

Kesireddy,

Elsayed,

Shostrom

et al. 2024

Cancers

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Background: Metastatic triple-negative breast cancer (TNBC) is aggressive with poor median overall survival (OS) ranging from 8 to 13 months. There exists considerable heterogeneity in survival at the individual patient level. To better understand the survival heterogeneity and improve risk stratification, our study aims to identify the factors influencing survival, utilizing a large patient sample from the National Cancer Database (NCDB). Methods: Women diagnosed with metastatic TNBC from 2010 to 2020 in the NCDB were included. Demographic, clinicopathological, and treatment data and overall survival (OS) outcomes were collected. Kaplan–Meier curves were used to estimate OS. The log-rank test was used to identify OS differences between groups for each variable in the univariate analysis. For the multivariate analysis, the Cox proportional hazard model with backward elimination was used to identify factors affecting OS. Adjusted hazard ratios and 95% confidence intervals are presented. Results: In this sample, 2273 women had a median overall survival of 13.6 months. Factors associated with statistically significantly worse OS included older age, higher comorbidity scores, specific histologies, higher number of metastatic sites, presence of liver or other site metastases in those with only one metastatic site (excluding brain metastases), presence of cranial and extra-cranial metastases, lack of chemotherapy, lack of immunotherapy, lack of surgery to distant sites, lack of radiation to distant sites, and receipt of palliative treatment to alleviate symptoms. In the multivariate analysis, comorbidity score, histology, number of metastatic sites, immunotherapy, and chemotherapy had a statistically significant effect on OS. Conclusions: Through NCDB analysis, we have identified prognostic factors for metastatic TNBC. These findings will help individualize prognostication at diagnosis, optimize treatment strategies, and facilitate patient stratification in future clinical trials.

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Section: Discussionmentioning

confidence: 99%

Overall Survival and Prognostic Factors in Metastatic Triple-Negative Breast Cancer: A National Cancer Database Analysis

Kesireddy,

Elsayed,

Shostrom

et al. 2024

Cancers

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show abstract

“…Currently, there is no compelling prospective evidence supporting surgery or radiation to distant metastatic site in TNBC management. The SABR COMET study showed an OS advantage with stereotactic radiation in oligometastatic cancer (only 18 out of the 99 patients had breast cancer), but the NRG BR-00213 study done exclusively in breast cancer patients showed no OS benefit [38]. Similarly, randomized controlled data for surgery of the primary tumor have not demonstrated an OS benefit, and there are no randomized trials examining surgery of the distant metastatic sites [39].…”

Section: Discussionmentioning

confidence: 99%

Overall Survival and Prognostic Factors in Metastatic Triple-Negative Breast Cancer: an NCDB Analysis

Kesireddy,

Elsayed,

Shostrom

et al. 2024

Preprint

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Background: Metastatic triple-negative breast cancer (TNBC) is aggressive with a poor median overall survival (OS), ranging from 8 to 13 months. There exists considerable heterogeneity in the survival at the individual patient level. To better understand the survival heterogeneity and improve risk stratification, our study aims to identify the factors influencing survival utilizing a large patient sample in the National Cancer Database (NCDB). Methods: Women diagnosed with metastatic TNBC from 2010 to 2020 in the NCDB were included. Demographic, clinic-pathological, treatment data, and overall survival (OS) outcomes were collected. Kaplan-Meier curves were used to estimate OS. The log-rank test was used to identify OS differences between groups for each variable in the univariate analysis. For the multivariate analysis, the Cox proportional hazard model with backward elimination was used to identify factors affecting OS. Adjusted hazard ratios and 95% confidence intervals are presented. Results: 2,273 women had a median overall survival of 13.6 months. Factors associated with statistically significantly worse OS included older age, higher comorbidity scores, specific histologies, higher number of metastatic sites, presence of liver or other site metastases in those with only one metastatic site (excluding brain metastases), presence of cranial and extra-cranial metastases, lack of chemotherapy, lack of immunotherapy, lack of surgery to distant sites, lack of radiation to distant sites, and receipt of palliative treatment to alleviate symptoms. In the multivariate analysis, comorbidity score, histology, number of metastatic sites, immunotherapy, and chemotherapy had a statistically significant effect on the OS. Conclusions: Through NCDB analysis, we have identified prognostic factors for metastatic TNBC. These findings will help improve prognostication at diagnosis, optimize treatment strategies, and facilitate patient stratification in future clinical trials.

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“…However, there is no universal definition for oligometastasis, and the definitions vary in literature and depending on the primary cancer site. Some studies propose less than three metastases, some less than four metastases confined to a single organ, while there are also studies including metastases to multiple sites [53,54].…”

Section: Oligometastatic Disease In Pancreatic Cancermentioning

confidence: 99%

“…Local therapy with surgery or stereotactic radiation of oligometastatic disease was superior regarding overall survival, compared to systemic therapy alone [55,56]. In breast cancer, oligometastasized disease (defined as no more than five metastases) was first mentioned in 2007, and a multidisciplinary strategy including local treatment of metastasis with surgery or stereotactic radiation is recommended [53,57].…”

Section: Oligometastatic Disease In Pancreatic Cancermentioning

confidence: 99%

Therapy of Locally Advanced and Oligometastatic Pancreatic Adenocarcinoma

Wahler,

Damanakis,

Große Hokamp

et al. 2023

Cancers

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Pancreatic adenocarcinoma is a lethal disease, and surgical resection remains the only curative treatment option. Unfortunately, upon primary diagnosis, only 15–20% of all patients with pancreatic ductal adenocarcinoma (PDAC) have localized disease that is eligible for operation. The remainder of patients either have borderline resectable or locally advanced disease or present with distant metastasis. In this review, we present a comprehensive overview regarding the current strategies and future directions in the multimodal therapy of locally advanced and oligometastasized pancreatic adenocarcinoma and discuss the benefit of surgery following neoadjuvant therapy in these patients.

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Local treatment in oligometastasis from breast cancer: an overview

Cited by 3 publications

References 34 publications

Overall Survival and Prognostic Factors in Metastatic Triple-Negative Breast Cancer: A National Cancer Database Analysis

Overall Survival and Prognostic Factors in Metastatic Triple-Negative Breast Cancer: A National Cancer Database Analysis

Overall Survival and Prognostic Factors in Metastatic Triple-Negative Breast Cancer: an NCDB Analysis

Therapy of Locally Advanced and Oligometastatic Pancreatic Adenocarcinoma

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