Survival impact of primary tumor resection in de novo metastatic breast cancer patients (GEICAM/El Alamo Registry)

Abstract

The debate about surgical resection of primary tumor (PT) in de novo metastatic breast cancer (MBC) patients persists. We explored this approach’s outcomes in patients included in a retrospective registry, named El Álamo, of breast cancer patients diagnosed in Spain (1990–2001). In this analysis we only included de novo MBC patients, 1415 of whom met the study’s criteria. Descriptive, Kaplan-Meier and Cox regression analyses were carried out. Median age was 63.1 years, 49.2% of patients had single-organ metastasis (skin/soft tissue [16.3%], bone [33.8%], or viscera [48.3%]). PT surgery (S) was performed in 44.5% of the cases. S-group patients were younger, had smaller tumors, higher prevalence of bone and oligometastatic disease, and lower prevalence of visceral involvement. With a median follow-up of 23.3 months, overall survival (OS) was 39.6 versus 22.4 months (HR = 0.59, p < 0.0001) in the S- and non-S groups, respectively. The S-group OS benefit remained statistically and clinically significant regardless of metastatic location, histological type, histological grade, hormone receptor status and tumor size. PT surgery (versus no surgery) was associated with an OS benefit suggesting that loco-regional PT control may be considered in selected MBC patients. Data from randomized controlled trials are of utmost importance to confirm these results.

Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER-based study

“…A study of 815 patients with de novo or recurrent metastatic breast cancer identified that patients with visceral metastases and those with multiple metastatic sites had worse OS, findings consistent with our results [23]. The five-year survival rate was 33.9%, which is similar to that in previous studies, which showed that 24-39% of patients lived 5 years after the diagnosis of bone metastases [5]. This may be because the subjects of this study were menopausal women, while there was no limitation on the age of the previous study subjects; moreover, the proportion of elderly patients was large and their prognosis was poor, and with the improvement of treatment methods in recent years, the prognosis of patients has been improved.…”

Prognostic&nbsp;factors&nbsp;and survival according to tumour subtype in women presenting with breast cancer bone&nbsp;metastases at initial diagnosis:&nbsp;a SEER based study

“…Study of 815 patients with denovo or recurrent metastatic breast cancer and identi ed that patients with visceral metastases as well as those with multiple metastatic sites had worse OS, ndings consistent with our results [23]. The ve year survival rate is 33.9% which is similar with previous studies that shown 24-39% of patients alive in ve year after diagnosis of bone metastases [5]. It may be due to the fact that the subjects of this study are menopausal women, the age of the previous subjects is unlimited, the proportion of elderly patients is large and the prognosis is poor, and with the improving of treatment methods in recent years, the prognosis of the patients has been improved.…”

“…Approximately 5-10% of patients have distant metastases at the time of diagnosis [2,3], bone is the most common site of metastasis in breast cancer patients, above 55% of breast cancer patients developing bone metastases [4]. Bone metastases are associated with lower survival in patients with advanced breast cancer [5]. And study showed that patients with breast cancer survive a median of 22-57.6 months after detection of bone metastases [6][7][8].…”

Prognostic&nbsp;factors&nbsp;and survival according to tumour subtype in women presenting with breast cancer bone&nbsp;metastases at initial diagnosis: a SEER-based study

“…A study of 815 patients with de novo or recurrent metastatic breast cancer identi ed that patients with visceral metastases and those with multiple metastatic sites had worse OS, ndings consistent with our results [23]. The ve-year survival rate was 33.9%, which is similar to that in previous studies, which showed that 24-39% of patients lived ve years after the diagnosis of bone metastases [5]. This may be because the subjects of this study were menopausal women, while there was no limitation on the age of the previous study subjects; moreover, the proportion of elderly patients was large and their prognosis was poor, and with the improvement of treatment methods in recent years, the prognosis of patients has been improved.…”