Survival Benefit of Surgical Removal of Primary Tumor in Patients With Stage IV Breast Cancer

Kim, Hye Jin; Kang, Eunyoung; Kim, Jee Hyun; Kim, Se Hyun; Kim, Yu Jung; Kim, In Ah; Eom, Keun Yong; Chae, Su Min; Kang, Kyu Min; Kim, Eun Kyu; Kim, Sung Won

doi:10.1016/j.clbc.2018.05.005

Cited by 6 publications

(3 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although surgery for stage IV breast cancer is still debated, a lot of studies have focused on it and demonstrated surgery to be effective in at least a selected population (11)(12)(13)(14)(15)(16)). Yet, evidence about the role of radiotherapy is rare.…”

Section: Introductionmentioning

confidence: 99%

Impact of Postoperative Radiotherapy on Survival of Patients With de novo Stage IV Breast Cancer: A Population-Based Study From the SEER Database

et al. 2021

View full text Add to dashboard Cite

Purpose: In our study, we aimed to evaluate the role of postoperative radiotherapy for patents with de novo stage IV breast cancer.Patients and Methods: Patients diagnosed with stage IV breast cancer from 2010 to 2016 were selected from the Surveillance, Epidemiology, and End Result (SEER) database. Those patients who received both chemotherapy and surgery and lived longer than 6 months were divided into radiotherapy and non-radiotherapy groups. Kaplan-Meier analysis and multivariate Cox proportional hazards models were used to estimate the survival outcomes before and after being 1:1 propensity score matched (PSM). Subgroup analyses stratified by age, subtype, status of distant metastasis, and surgery type were also performed.Results: Among 1,935 patients, 52% (1006) underwent radiotherapy while the non-radiotherapy group contained 48% (929). After PSM, a total of 1,520 patients in two groups of 760 patients were enrolled in this analysis. Kaplan-Meier and the multivariate survival analysis demonstrated that the radiotherapy group presented with a better prognosis compared to the non-radiotherapy group (after PSM, BCSS: Hazard Ratio, 0.697; 95% confidence interval, 0.59–0.823; P < 0.001; OS: Hazard Ratio, 0.707; 95% confidence interval, 0.601–0.831; P < 0.001). Further subgroup analyses showed the Luminal subtype (HR+/HER2–), triple-negative breast cancer (TNBC), and bone-only metastasis patients presented with the most promising survival in the radiotherapy group.Conclusions: Postoperative radiotherapy is associated with a significant survival advantages in BCSS and OS. It can be an optimal supplementary treatment for stage IV patients after surgery, especially for Luminal subtype, TNBC, and patients with a low metastatic burden.

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of Postoperative Radiotherapy on Survival of Patients With de novo Stage IV Breast Cancer: A Population-Based Study From the SEER Database

et al. 2021

View full text Add to dashboard Cite

show abstract

“…4 Based on a single-centre data, Kim's group found that the removal of primary breast tumours was a significant independent beneficial predictor for survival. 5 Strengths and limitations of this study ► Surveillance, Epidemiology, and End Results (SEER) database is a large database of US patients with cancer, but no chemotherapy information was included in this database. ► In SEER database, non-surgery patients were divided into recommended but refuse group and not recommended group, which subdivided patients more precisely.…”

Section: Introductionmentioning

confidence: 99%

“…Based on Surveillance, Epidemiology, and End Results Programme (SEER) registry data from 1988 to 2011, Thomas et al suggested that primary tumour surgery is associated with improved survival 4. Based on a single-centre data, Kim’s group found that the removal of primary breast tumours was a significant independent beneficial predictor for survival 5. However, in the open-label randomised controlled trial, only patients with bone and visceral MBC were included 6.…”

Section: Introductionmentioning

confidence: 99%

Impact of surgical management of primary tumors in stage IV breast cancer patients: a retrospective observational study based on SEER database

et al. 2022

View full text Add to dashboard Cite

ObjectivesAlthough primary tumour surgery could prolong survival for patients with stage IV breast cancer, how to select candidates for primary tumour surgery is still a challenging problem for medical oncologists.DesignThis study is a retrospective database study.Setting and participantsIn this study, we aimed at evaluating the primary site surgery effect and select the beneficial subgroups. 13 618 patients with stage IV breast cancer, diagnosed between 2010 and 2015, were collected from SEER*Stat database.InterventionsBased on the local surgery at primary tumour site, patients were categorised into three groups: primary tumour surgery performed group, recommended for primary tumour surgery but refused (RBR) group and surgery not recommended (NR) group.Primary and secondary outcome measuresAll-cause survival and breast cancer-specific survival (BCSS).ResultsUnivariate Cox regression analyses showed that, compared with surgery group, patients in non-surgery (RBR and NR) groups tend to be older, T4, N0/NX, triple-negative and visceral metastatic. For both all-cause survival and BCSS, non-surgery, advanced T stage, triple-negative BC (TNBC) and visceral metastases were significant risk factors. Primary tumour surgery showed benefits for both all-cause survival (HR=0.44, 95% CI=0.39–0.49, p<0.0001) and BCSS (HR=0.43, 95% CI=0.38–0.49, p<0.0001). However, after propensity score matching, primary tumour surgery failed to demonstrate significant benefits for TNBC (HR=0.96, 95% CI=0.60–1.53, p=0.851) and patients with visceral metastases (HR=0.90, 95% CI=0.60–1.36, p=0.62).ConclusionSurgery was associated with prolonged survival in stage IV breast cancers, but not in patients with TNBC and visceral metastases.

show abstract

Surgery of the primary tumor in patients with de novo metastatic breast cancer: a nationwide population-based retrospective cohort study in Belgium

Brandão,

Martins-Branco,

De Angelis

et al. 2023

Breast Cancer Res Treat

View full text Add to dashboard Cite

Survival Benefit of Surgical Removal of Primary Tumor in Patients With Stage IV Breast Cancer

Cited by 6 publications

References 33 publications

Impact of Postoperative Radiotherapy on Survival of Patients With de novo Stage IV Breast Cancer: A Population-Based Study From the SEER Database

Impact of Postoperative Radiotherapy on Survival of Patients With de novo Stage IV Breast Cancer: A Population-Based Study From the SEER Database

Impact of surgical management of primary tumors in stage IV breast cancer patients: a retrospective observational study based on SEER database

Surgery of the primary tumor in patients with de novo metastatic breast cancer: a nationwide population-based retrospective cohort study in Belgium

Contact Info

Product

Resources

About