Results of lung metastasectomy from breast cancer: prognostic criteria on the basis of 467 cases of the international registry of lung metastases

Friedel, Godehard; Pastorino, Ugo; Ginsberg, Robert J.; Goldstraw, Peter; Johnston, Mary; Pass, Harvey I.; Putnam, Joe B.; Toomes, H.

doi:10.1016/s1010-7940(02)00331-7

Cited by 236 publications

(179 citation statements)

References 12 publications

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“…These recurrences may also be treated surgically if they again fulfil the general indication criteria for metastasectomy and the patient wishes to have a repeat metastasectomy. In the study by Friedel et al the subgroup of patients with repeat metastasectomy achieved a 40 % five-year survival rate which was better than that of the study collective overall (35 %) [2]. Following repeated metastasectomy median post-metastasectomy survival was approximately 47 months in the study by Meimarakis et al [11].…”

Section: Survival After Metastasis Surgerymentioning

confidence: 89%

“…Complete resectability of all lung lesions is considered to be the most important indication criterion for lung metastasis of surgery. Patients with R 0 resection had a statistically significant survival advantage in three out of four case series [2,10,11]. In the study by Welter and colleagues patients with R 0 -and R 1 resections (median survival: approx.…”

Section: Prognostic Factors For Survival After Metastasis Surgerymentioning

confidence: 94%

“…The literature search performed on 15 February 2017 had 2426 hits in MEDLINE and found one review article in the Cochrane library. After step-wise appraisal 11 studies where identified each with at least 20 patients having had lung metastasectomy following primary tumour treatment with curative intent [2][3][4][5][6][7][8][9][10][11][12].…”

Section: Methodsmentioning

confidence: 99%

“…Ten of the reviewed studies were case series, together reporting on over 971 patients with treated breast carcinoma and pulmonary metastasectomy [2][3][4][5][6][7][8][9][10][11]. Operations were performed between 1960 and 2007.…”

Section: Methodsmentioning

confidence: 99%

“…Pulmonary metastasectomy resulted in a median post-metastasectomy survival of 32 to 96.6 months (▶ Table 2) [2][3][4][5][8][9][10][11]. Five-year survival rates were between 30.8 and 54.4 %, while 10-year survival rates were between 18 and 51 % [2][3][4][5][6][7][8][9][10]. One meta-analysis from the year 2015 analysed the survival prognosis of patients with breast carcinoma after lung metastasis surgery quantitatively [12].…”

Section: Survival After Metastasis Surgerymentioning

confidence: 99%

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Lung Metastasectomy for Pulmonary Metastatic Breast Carcinoma

Macherey

Mallmann

Malter

et al. 2017

Geburtshilfe Frauenheilkd

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ABSTR AC TBreast carcinoma with pulmonary metastasis can be treated locally or systemically. Following primary tumour resection patients with isolated, completely resectable pulmonary nodules and definite functional operability can be offered lung metastasis resection. Following metastasectomy a median survival of 32 to 96.6 months can be achieved with corresponding five-year survival rates between 30.8 and 54.4 %. The procedure is associated with a mortality rate of 0 to 3 %. The most important independent prognostic factor for longterm survival is complete resection of all lung lesions. The configuration and pattern of metastasis as well as disease-free interval, hormone and HER2/neu receptor status also appear to influence prognosis, but are of lesser importance. Intrapulmonary recurrence of metastases may, after careful selection on a case-by-case basis, also be treated operatively. In some cases this is associated with a favourable long-term prognosis. Pulmonary metastasectomy should be the treatment of choice for selected patients with metastatic breast carcinoma. ZUSAMMENFASSUNG

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Section: Survival After Metastasis Surgerymentioning

confidence: 89%

Section: Prognostic Factors For Survival After Metastasis Surgerymentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Survival After Metastasis Surgerymentioning

confidence: 99%

See 3 more Smart Citations

Lung Metastasectomy for Pulmonary Metastatic Breast Carcinoma

Macherey

Mallmann

Malter

et al. 2017

Geburtshilfe Frauenheilkd

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Risk factors and survival outcomes in patients with breast cancer and lung metastasis: a population‐based study

et al. 2018

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The risk factors for morbidity and mortality in breast cancer lung metastases (BCLM) patients still remain poorly identified. The aim of this study was to assess the incidence and survival of BCLM and associated risk factors. Patients with BCLM were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate logistic regression analysis was used to determine the risk factors for BCLM. Predictors of factors associated with death were analyzed in Cox regression and Fine and Gray's test. Of the 11568 patients with stage IV breast cancer, 4213 (36.4%) had BCLM and 1214 (10.5%) had metastases confined to lungs. The median survival time for patients with BCLM was 21 months, and 15.5% of the patients were alive more than 3 years. The tumor subtype distribution was 45.3% HR−/HER2−, 12.2% HR+/HER2+, 7.8% HR−/HER2+, and 15.0% triple‐negative subtype. Compared with patients without BCLM, those with BCLM were more likely to be aged, female, black, higher tumor grade, HR−/HER2+, HR+/HER2+, and triple‐negative subtypes at diagnosis. Survival analysis showed that the aged, black race, HR−/HER2+, triple‐negative subtype, higher grade were the independent risk factor for BCLM patients’ survival, while HR+/HER2+ subtype, insured status, and married status suggested better prognosis. In conclusion, the incidence and prognosis of BCLM varied by tumor subtypes, age, and race. Elderly patients with HER2‐positive or triple‐negative tumors were more likely to have BCLM.

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Uncertain benefit from surgery in patients with lung metastases from breast carcinoma

Planchard

Soria

Michiels

et al. 2003

Cancer

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BACKGROUND Isolated lung metastases have been reported to occur in 10–20% of all women with breast carcinoma. The authors described a series of patients who underwent surgery for lung metastases from breast carcinoma. METHODS They reviewed the files of 125 consecutive patients who underwent surgery with a curative intent for lung metastases from breast carcinoma between 1972 an 1998 at a single institution. Survival curves were plotted by the Kaplan–Meier method. Prognostic factors were identified using the log‐rank test and a Cox proportional hazards model for univariate and multivariate analyses, respectively. RESULTS The median age at surgery was 53 years. There was a median of 1 resected metastasis (range, 1–16 resected metastases). The median size of the largest metastasis was 19 mm (range, 5–70 mm). The median disease‐free interval (DFI) was 3 years. The median follow‐up time after surgery was 8.5 years (range, 25 days to 22 years). The 3‐year, 5‐year, and 10‐year probabilities of survival were 58% (95% confidence interval [95% CI], 49–67%), 45% (95% CI, 36–55%), and 30% (95% CI, 21–41%), respectively. The median survival time after surgery was 4.2 years. Complete resection was achieved in 96 patients. The quality of the resection (complete vs. incomplete) was not a statistically significant prognostic factor by univariate analysis and there was no significant difference between these two groups in terms of adjuvant postoperative therapy. The characteristics of the primary tumor and the number of metastases (one vs. two or more) had no detectable influence on survival. The size of the largest metastasis (> 20 mm or ≤ 20 mm) and the DFI (≤ 3 years vs. > 3 years) were highly significant prognostic factors (P = 0.006 and P = 0.003, respectively). This was confirmed by multivariate analysis. Patients with a DFI ≤ 3 years and/or the largest metastasis > 20 mm reportedly had a poor outcome (median survival, 2.6 years vs. 8.5 years for patients with none of these poor prognostic factors). CONCLUSIONS Resection of lung metastases from breast carcinoma was associated with a significant 5‐year survival rate of 45%. Whether these encouraging findings resulted from the surgical procedure itself or the preoperative selection of patients remained uncertain. When surgery is considered in this setting, the size of the largest metastasis and the DFI should be taken into account. Cancer 2004;100:28–35.© 2003 American Cancer Society.

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Results of lung metastasectomy from breast cancer: prognostic criteria on the basis of 467 cases of the international registry of lung metastases

Abstract: Considering the low morbidity and mortality rate, we think that lung metastasectomy today is the best treatment option in selected cases of lung metastases from breast cancer.

Cited by 236 publications

References 12 publications

Lung Metastasectomy for Pulmonary Metastatic Breast Carcinoma

Lung Metastasectomy for Pulmonary Metastatic Breast Carcinoma

Risk factors and survival outcomes in patients with breast cancer and lung metastasis: a population‐based study

Uncertain benefit from surgery in patients with lung metastases from breast carcinoma

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