Metastasectomy and Surgical Resection of the Primary Tumor in Patients With Stage IV Breast Cancer

Pockaj, Barbara A.; Wasif, Nabil; Dueck, Amylou C.; Wigle, Dennis A.; Boughey, Judy C.; Degnim, Amy C.; Gray, Richard; McLaughlin, Sarah A.; Northfelt, Donald W.; Sticca, Robert P.; Jakub, James W.; Perez, Edith A.

doi:10.1245/s10434-010-1016-1

Cited by 66 publications

(43 citation statements)

References 52 publications

(63 reference statements)

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“…A clinician and a patient may consider surgical resection of the primary tumour in this setting for multiple reasons 29 .…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, other hypotheses suggest that resection of the primary tumour may reduce the risk of metastasis growth. In theory, the primary tumour acts as a "seed source" for the development of new metastases, and its resection could potentially lower the chances of further progression 5,29,39 . Another hypothesis is that resection of primary tumour reduces the burden of disease and potentially makes chemotherapy more effective 29 .…”

Section: Discussionmentioning

confidence: 99%

“…In theory, the primary tumour acts as a "seed source" for the development of new metastases, and its resection could potentially lower the chances of further progression 5,29,39 . Another hypothesis is that resection of primary tumour reduces the burden of disease and potentially makes chemotherapy more effective 29 . There is also a counterargument that removing a primary tumour can promote cancer cell proliferation by suppressing cell-mediated immunity 40 .…”

Section: Discussionmentioning

confidence: 99%

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Excision of the Primary Tumour in Patients with Metastatic Breast Cancer: A Clinical Dilemma

et al. 2012

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Background: Approximately 10% of new breast cancer patients will present with overt synchronous metastatic disease. The optimal local management of those patients is controversial. Several series suggest that removal of the primary tumour is associated with a survival benefit, but the retrospective nature of those studies raises considerable methodologic challenges. We evaluated our clinical experience with the management of such patients and, more specifically, the impact of surgery in patients with synchronous metastasis. Methods: We reviewed patients with primary breast cancer and concurrent distant metastases seen at our centre between 2005 and 2007. Demographic and treatment data were collected. Study endpoints included overall survival and symptomatic local progression rates. Results: The 111 patients identified had a median follow-up of 40 months (range: 0.6–71 months). We allocated the patients to one ot two groups: a nonsurgical group (those who did not have breast surgery, n = 63) and a surgical group (those who did have surgery, n = 48, 29 of whom had surgery before the metastatic diagnosis). When compared with patients in the nonsurgical group, patients in the surgical group were less likely to present with T4 tumours (23% vs. 35%), N3 nodal disease (8% vs. 19%), and visceral metastasis (67% vs. 73%). Patients in the surgical group experienced longer overall survival (49 months vs. 33 months, p = 0.01) and lower rates of symptomatic local progression (14% vs. 44%, p < 0.001). Conclusions: In our study, improved overall survival and symptomatic local control were demonstrated in the surgically treated patients; however, this group had less aggressive disease at presentation. The optimal local management of patients with metastatic breast cancer remains unknown. An ongoing phase iii trial, E2108, has been designed to assess the effect of breast surgery in metastatic patients responding to first-line systemic therapy. If excision of the primary tumour is associated with a survival benefit, then the preselected subgroup of patients who have responded to initial systemic therapy is the desired population in which to put this hypothesis to the test.

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“…A clinician and a patient may consider surgical resection of the primary tumour in this setting for multiple reasons 29 .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Excision of the Primary Tumour in Patients with Metastatic Breast Cancer: A Clinical Dilemma

et al. 2012

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“…On the other hand, we have several reports about liver metastasectomy in metastatic BC but these series included small cohort of patients widely different for inclusion criteria and type of systemic therapy received; the reported 5-year survival rate varies from 18% to 61%. 11 In the last decade, different local treatment options have been introduced as an alternative to surgery, including radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT).…”

Section: State Of the Artmentioning

confidence: 99%

The role of SBRT in oligometastatic patients with liver metastases from breast cancer

Scorsetti

Franceschini

Rose

et al. 2017

Reports of Practical Oncology & Radiotherapy

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Liver Metastases SBRT Radiotherapy a b s t r a c tLiver metastases from breast cancer are a common occurrence. Local ablative therapies are a promising therapeutic option for these patients, with the potential for a long term disease control in the setting of "oligometastatic patients". Identification of the perfect candidate for local approaches is still challenging and unclear. Stereotactic body radiation therapy (SBRT) is one of the most valuable local therapy, because of great efficiency, low morbidity and minimal invasiveness. In this paper, we reviewed the state of the art in the care of breast cancer patients with liver metastases, with a focus on SBRT.© 2016 Greater Poland Cancer Centre. Published by Elsevier Sp. z o.o. All rights reserved. 1.State of the art E-mail address: marta.scorsetti@humanitas.it (M. Scorsetti).Firstly in 1995, Hellman and Weichselbaum 1 described the state, called oligometastatic disease, characterized by an indolent tumor biology and behavior in which metastases are limited in number and site. In this subgroup of selected patients, the emerging data is that local therapy could have a potential curative role and an impact on survival rate.The population with oligometastatic BC (OM BC) is estimated to be 1-10% of newly diagnosed patients with metastatic BC 2 and is well represented in the subgroup of http://dx

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“…The tumors which arose later are named the 'secondary' tumors or metastases. Early diagnose and extirpation of "primary tumor" (the first appeared cancer site) may improve metastatic progression-free survival but does not exclude subsequent appearance of "secondary tumors" [54,55].…”

Section: The Hypothesis Of Genome Intrusionmentioning

confidence: 99%

Functions of hereditary immunity and xenogamy in cancer origin and pandemic spread

Rumyantsev¹

2011

OJI

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The efficacy of means exploited currently for cancer prevention and treatment appeared to be very low. New insights into the origin of the disease are sorely needed. The present article synthesizes the results from integrative reconsideration of actual data on cancer from the viewpoint of recent developments in pathology, epidemiology, immunology, genetics, and evolution. In contrast to the 80 years old hypothesis of somatic mutative origin of carcinogenesis, the revealed set of evidence showed the origin of cancerous clones is based on inherent constitutional incongruence between the regulators of cell physiology and their targets realized in inherent immunity of cancerous cells to normal regulation of cell replication and tissue growth. The incongruence arises out of both genome mutations which led to interethnic differences in the regulator-receptor structures and intercourse between ethnoses, the regulator-receptor evolution of which has been processed to deal with different ecologic conditions. The current pandemic spread of cancer is brought about growing expansion of interethnic xenogamy favored by growing industrialization, urbanization, globalization, and migration. The proposed hypothesis of genome intrusion in the origin of cancer induces new research ideas and proposals for cancer prevention and therapy.

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Metastasectomy and Surgical Resection of the Primary Tumor in Patients With Stage IV Breast Cancer

Cited by 66 publications

References 52 publications

Excision of the Primary Tumour in Patients with Metastatic Breast Cancer: A Clinical Dilemma

Excision of the Primary Tumour in Patients with Metastatic Breast Cancer: A Clinical Dilemma

The role of SBRT in oligometastatic patients with liver metastases from breast cancer

Functions of hereditary immunity and xenogamy in cancer origin and pandemic spread

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