Survival Impact of Locoregional Treatment of the Primary Tumor in De Novo Metastatic Breast Cancers in a Large Multicentric Cohort Study: A Propensity Score-Matched Analysis

Pons‐Tostivint, Elvire; Kirova, Youlia; Lusque, Amélie; Campone, Mario; Geffrelot, Julien; Mazouni, Chafika; Mailliez, Audrey; Pasquier, David; Madranges, Nicolas; Firmin, Nelly; Crouzet, Agathe; Gonçalvès, Anthony; Jankowski, Clémentine; Rouge, Thibault De La Motte; Pouget, Nicolas; Lande, B. De La; Mouttet-Boizat, Delphine; Ferrero, Jean-­Marc; Uwer, Lionel; Eymard, Jean‐Christophe; Mouret-Reynier, Marie-Ange; Petit, Thierry; Robain, Mathieu; Filleron, Thomas; Cailliot, Christian

doi:10.1245/s10434-018-6831-9

Cited by 47 publications

(61 citation statements)

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“…For patients with de novo metastatic disease, a potential explanation for the impact of age on OS, is a higher rate of loco-regional treatments in younger patients. Loco-regional treatments are known to be more frequently performed in younger patients and to be associated with better outcomes [ 17 , [27] , [28] , [29] ]. Furthermore, recent prospective data also suggested that locoregional treatment of de novo MBC may improve long term prognosis [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…The ESME Research program included 3 types of cancer: MBC, ovarian and lung cancers. It involves 18 academic cancer centers managing together over one-third of all BC cases nationwide; for MBC, other citations are available [ [15] , [16] , [17] , [18] ]. We used the ESME MBC database (NCT03275311) to evaluate the impact of age at MBC diagnosis on overall survival (OS).…”

Section: Introductionmentioning

confidence: 99%

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Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life ESME metastatic breast cancer cohort

Frank

Carton²,

Dubot³

et al. 2020

The Breast

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Background Young age is a poor prognostic factor in early stage breast cancer (BC) but its value is less established in metastatic BC (MBC). We evaluated the impact of age at MBC diagnosis on overall survival (OS) across three age groups (<40, 40 to 60 and > 60 years(y)). Methods ESME MBC database is a national cohort, collecting retrospective data from 18 participating French cancer centers between January 01, 2008 and December 31, 2014. Results Among 14 403 women included, 1077 (7.5%), 6436 (44.7%) and 6890 (47.8%) pts were <40, 40–60 and > 60 y respectively. Pts <40 had significantly more aggressive presentations than other age groups: more frequent HER2+ (25.7 vs 15.3% in >60y) and triple negative subtypes (27.4 vs 14.6% in >60y), and more frequent visceral involvement (36.3 vs 29.8% in >60y). At a median follow-up of 48 months, median OS differed across age groups: 38.8, 38.4 and 35.6 months for pts <40, 40–60 and > 60y, respectively (p < 0.0001). Compared to pts <40y, older pts had a statistically significant higher risk of death (all causes of death included), although of limited clinical value (HR = 1.1, IC 95%:1.01–1.20). There was a significant trend for better OS in pts <40y with HER2+ and luminal diseases. A possible explanation is a greater use of anti-Her2 therapies as first-line treatments: 86.6, 81.9 and 74.9% for pts <40, 40–60 and > 60y, respectively (p < 0.0001). Conclusion Although young age seems associated with more aggressive presentations at diagnosis of MBC, it has no deleterious effect on OS in this large series.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life ESME metastatic breast cancer cohort

Frank

Carton²,

Dubot³

et al. 2020

The Breast

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“…A multicenter, phase III, randomized, controlled trial MF07-01 indicated that locoregional treatment could improve 5-years survival in de novo stage IV breast cancer patients (26). A recently published multicentric retrospective study in France indicated that locoregional treatment improved overall survival in breast cancer patients with synchronous metastasis, especially in patients with the molecular subtype of HR-positive/HER2-negative and HER2positive (27). Another retrospective study in Chinese patients showed that surgical removal of the primary tumor could improve the prognosis of patients with bone metastasis alone (28).…”

Section: Discussionmentioning

confidence: 99%

A Risk Stratification Model for Predicting Overall Survival and Surgical Benefit in Triple-Negative Breast Cancer Patients With de novo Distant Metastasis

Wang

Sun

et al. 2020

Front. Oncol.

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Background and Aims: This research aimed to construct a novel model for predicting overall survival (OS) and surgical benefit in triple-negative breast cancer (TNBC) patients with de novo distant metastasis.Methods: We collected data from the Surveillance, Epidemiology, and End Results (SEER) database for TNBC patients with distant metastasis between 2010 and 2016. Patients were excluded if the data regarding metastatic status, follow-up time, or clinicopathological information were incomplete. Univariate and multivariate analyses were applied to identify significant prognostic parameters. By integrating these variables, a predictive nomogram and risk stratification model were constructed and assessed with C-indexes and calibration curves.Results: A total of 1,737 patients were finally identified. Patients enrolled from 2010 to 2014 were randomly assigned to two cohorts, 918 patients in the training cohort and 306 patients in the validation cohort I, and 513 patients enrolled from 2015 to 2016 were assigned to validation cohort II. Seven clinicopathological factors were included as prognostic variables in the nomogram: age, marital status, T stage, bone metastasis, brain metastasis, liver metastasis, and lung metastasis. The C-indexes were 0.72 [95% confidence interval [CI] 0.68-0.76] in the training cohort, 0.71 (95% CI 0.68-0.74) in validation cohort I and 0.71 (95% CI 0.67-0.75) in validation cohort II. Calibration plots indicated that the nomogram-based predictive outcome had good consistency with the recoded prognosis. A risk stratification model was further generated to accurately differentiate patients into three prognostic groups. In all cohorts, the median overall survival time in the low-, intermediate-and high-risk groups was 17.0 months (95% CI 15.6-18.4), 11.0 months (95% CI 10.0-12.0), and 6.0 months (95% CI 4.7-7.3), respectively. Locoregional surgery improved prognosis in both the low-risk [hazard ratio [HR] 0.49, 95% CI 0.41-0.60, P < 0.0001] and intermediate-risk groups (HR 0.55, 95% CI 0.46-0.67, P < 0.0001), but not in high-risk group (HR 0.73, 95% CI 0.52-1.03, P = 0.068). All stratified groups could prognostically benefit from chemotherapy (low-risk group: HR 0.50, 95% CI 0.35-0.69, P < 0.0001; intermediate-risk group: HR 0.34, Wang et al.Predictive Model for Metastatic TNBC 95% CI 0.26-0.44, P < 0.0001; and high-risk group: HR 0.16, 95% CI 0.10-0.25, P < 0.0001). Conclusion:A predictive nomogram and risk stratification model were constructed to assess prognosis in TNBC patients with de novo distant metastasis; these methods may provide additional introspection, integration and improvement for therapeutic decisions and further studies.

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“… 6 , 7 In this review, we would like to focus on the recent publications specifically those with larger same sizes looking at the role of LRT for de novo stage IV BC ( Table 1 ). A French study by Pons-Tostivint et al 8 in 2019 describes a 35% survival benefit with LRT, HR = 0.65. This study focuses on the tumor subtype, metastatic sites, and overall disease burden as potential predictors of benefit from LRT.…”

Section: Retrospective Studiesmentioning

confidence: 98%

Role of Locoregional Treatment in De Novo Stage IV Breast Cancer

Lee

Toktaş

Soran

2020

Clin Med Insights Oncol

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It is estimated that approximately 154000 women in the United States have stage IV breast cancer (BC). A subset of this group has metastatic disease at presentation, known as de novo stage IV disease. De novo stage IV BC accounts for approximately 6% of all BC diagnoses in the United States. Traditionally, stage IV BC patients are treated with primary systemic therapy with a palliative intent reserving possible locoregional treatment (LRT) as last resort. There has been a lot of interest in the role of LRT in de novo stage IV BC for the past decade with mixed conclusions. Although this review is not intended to be a comprehensive overview of all literature regarding this topic to date, we will review the recent findings in literature focusing on the studies with larger sample sizes to investigate the role of LRT in de novo stage IV BC.

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Survival Impact of Locoregional Treatment of the Primary Tumor in De Novo Metastatic Breast Cancers in a Large Multicentric Cohort Study: A Propensity Score-Matched Analysis

Cited by 47 publications

References 35 publications

Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life ESME metastatic breast cancer cohort

Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life ESME metastatic breast cancer cohort

A Risk Stratification Model for Predicting Overall Survival and Surgical Benefit in Triple-Negative Breast Cancer Patients With de novo Distant Metastasis

Role of Locoregional Treatment in De Novo Stage IV Breast Cancer

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