Prognostic factors in patients with oligometastatic breast cancer – A systematic review

Ommen-Nijhof, Annemiek van; Steenbruggen, Tessa G; Schats, Winnie; Wiersma, T.; Horlings, Hugo M.; Mann, Ritse M.; Koppert, Linetta B.; Werkhoven, Erik van; Sonke, Gabe S.; Jager, Agnes

doi:10.1016/j.ctrv.2020.102114

Cited by 24 publications

(19 citation statements)

References 59 publications

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“…Hormone-receptor positivity was associated with better outcome and HER2-positivity with worse. This latter result must be weighted, however, since few patients received anti-HER2 therapy [ 55 ].…”

Section: Resultsmentioning

confidence: 99%

“…These include: a single metastasis, >24 months interval between primary tumor and OMBC, no or limited involvement of axillary lymph nodes at primary diagnosis and hormone-receptor positivity appear to be favorable prognostic factors. HER2-positivity seems to be an unfavorable prognostic factor, but most patients included in the studies did not receive anti-HER2 treatments [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis, biology and epidemiology of oligometastatic breast cancer

et al. 2021

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Does oligometastatic breast cancer (OMBC) deserve a dedicated treatment? Although some authors recommend multidisciplinary management of OMBC with a curative intent, there is no evidence proving this strategy beneficial in the absence of a randomized trial. The existing literature sheds little light on OMBC. Incidence is unknown; data available are either obsolete or biased; there is no consensus on the definition of OMBC and metastatic sites, nor on necessary imaging techniques. However, certain proposals merit consideration. Knowledge of eventual specific OMBC biological characteristics is limited to circulating tumor cell (CTC) counts. Given the data available for other cancers, studies on microRNAs (miRNAs), circulating tumor DNA (ctDNA) and genomic alterations should be developed Finally, safe and effective therapies do exist, but results of randomized trials will not be available for many years. Prospective observational cohort studies need to be implemented.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnosis, biology and epidemiology of oligometastatic breast cancer

et al. 2021

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“…( 50 ). Locoregional therapy for BC oligometastases accords with international guidelines ( 36 , 51 ) and has in recent years been reappraised in a Dutch metanalysis that proposed including, among the indications for a multidisciplinary approach, a single metastatic site ( 52 ). Others document long-term survivals and a possibility of a cure in numerous patients with a single metastatic site from BC treated with locoregional therapy (radiotherapy or surgery) associated with systemic therapy especially those with a low tumor burden ( 53 ).…”

Section: Discussionmentioning

confidence: 99%

Selected Patients With Peritoneal Metastases From Breast Cancer May Benefit From Cytoreductive Surgery: The Results of a Multicenter Survey

et al. 2022

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BackgroundEven though breast cancer is the most frequent extra-abdominal tumor causing peritoneal metastases, clear clinical guidelines are lacking. Our aim is to establish whether cytoreductive surgery (CRS) could be considered in selected patients with peritoneal metastases from breast cancer (PMBC) to manage abdominal spread and allow patients to resume or complete other medical treatments.MethodsWe considered patients with PMBC treated in 10 referral centers from January 2002 to May 2019. Clinical data included primary cancer characteristics (age, histology, and TNM) and data on metastatic disease (interval between primary BC and PM, molecular subtype, other metastases, and peritoneal spread). Overall survival (OS) was estimated using the Kaplan–Meier method. Univariate and multivariable data for OS were analyzed using the Cox proportional hazards model.ResultsOf the 49 women with PMBC, 20 were treated with curative aim (CRS with or without HIPEC) and 29 were treated with non-curative procedures. The 10-year OS rate was 27%. Patients treated with curative intent had a better OS than patients treated with non-curative procedures (89.2% vs. 6% at 36 months, p < 0.001). Risk factors significantly influencing survival were age at primary BC, interval between BC and PM diagnosis, extra-peritoneal metastases, and molecular subtype.ConclusionsThe improved outcome in selected cases after a multidisciplinary approach including surgery should lead researchers to regard PMBC patients with greater attention despite their scarce epidemiological impact. Our collective efforts give new information, suggest room for improvement, and point to further research for a hitherto poorly studied aspect of metastatic BC.

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“…They evaluated 1445 patients with bone-only metastasis followed for at least 6 months at MD Anderson Cancer Center from 1997 to 2015 and reported poorer OS in patients with multiple bone metastases (median OS, 4.80 years; 95% CI 4.49–5.07) compared with SBM (median OS, 7.54 years; 95% CI 6.28–10.10) 15 . In addition, in a systematic review examining prognostic factors on survival in patients with oligometastatic breast cancer, solitary metastasis was associated with better OS 8 . In a study of 50 patients with extracranial oligometastatic breast cancer, those with single metastasis highly benefited from systemic chemotherapy and surgical resection and gained survival advantage with statistical significance 16 .…”

Section: Discussionmentioning

confidence: 99%

“…In this context, oligometastatic breast cancer generally refers to a special group of patients with fewer than five metastatic deposits in a single organ and is considering potentially curable stage IV disease 7 . However, the definition of oligometastatic bone disease (OMBD) in the literature varies according to the number and location of metastasis 8 . It is still uncertain whether OMBD corresponds to an intermediate stage between localized and widespread disease or a genetically unique entity, rather than a transition point from a primary tumor to metastasis 9 .…”

Section: Introductionmentioning

confidence: 99%

Breast cancer patients with isolated bone metastases and oligometastatic bone disease show different survival outcomes

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et al. 2021

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In this study, we planned to investigate the clinical course of patients with breast cancer with oligometastatic bone disease (OMBD). The patients were grouped according to the characteristics and the sites of metastases. Group I included 928 patients without metastasis. Group II, the OMBD group, included 68 patients. Group III, the widespread metastasis group, comprised 185 patients with multiple bone metastases and/or solid organ metastases. The mean overall survival of the groups was 16.7 ± 0.3 years in group 1, and 7.8 ± 0.8 and 5.9 ± 0.4 years in groups 2 and 3, respectively (p < 0.001 for the comparison of all three groups together; p < 0.001 for group 1 vs. 2 and 3) and (p = 0.037 for group 2 vs. group 3). In the subgroup survival analysis of patients in group 2 (OMBD), the mean and median survival was 5.5 ± 0.8 and 4.0 ± 0.8 years vs. 9.2 ± 0.98 and 9.0 ± 1.05 years in patients with more than one bone metastasis and single bone metastasis, respectively (p = 0.019). OMBD seems to be a different disease than breast cancer with isolated bone metastases. The high risk of developing OMBD, especially following locoregional recurrence, increases the importance of locoregional therapy in large T and N stage tumors.

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Prognostic factors in patients with oligometastatic breast cancer – A systematic review

Cited by 24 publications

References 59 publications

Diagnosis, biology and epidemiology of oligometastatic breast cancer

Diagnosis, biology and epidemiology of oligometastatic breast cancer

Selected Patients With Peritoneal Metastases From Breast Cancer May Benefit From Cytoreductive Surgery: The Results of a Multicenter Survey

Breast cancer patients with isolated bone metastases and oligometastatic bone disease show different survival outcomes

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