Could local surgery improve survival in de novo stage IV breast cancer?

Autor: Xing Li, Guangzheng Deng, Zeyu Shuang, Zhenchong Xiong, Xinhua Xie, Jin Wang, Xi Wang
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Adult
Cancer Research
medicine.medical_specialty
Soft tissue metastasis
Biopsy
Population
Local surgery
Breast Neoplasms
Kaplan-Meier Estimate
Mastectomy
Segmental
lcsh:RC254-282
Metastasis
03 medical and health sciences
0302 clinical medicine
Breast cancer
Surgical oncology
Genetics
medicine
Humans
Neoplasm Metastasis
education
Survival analysis
Aged
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
education.field_of_study
De novo stage IV
business.industry
Bone metastasis
Middle Aged
medicine.disease
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Metastatic breast cancer
Primary tumor
Surgery
Primary tumor size
030104 developmental biology
Treatment Outcome
Oncology
030220 oncology & carcinogenesis
Female
business
Research Article
Zdroj: BMC Cancer, Vol 18, Iss 1, Pp 1-9 (2018)
BMC Cancer
ISSN: 1471-2407
Popis: Background Resection of the primary tumor is recommended for symptom relief in de novo stage IV breast cancer. We explored whether local surgery could provide a survival benefit in these patients and attempted to characterize the population that could benefit from surgery. Methods Metastatic Breast cancer patients (N = 313) with intact primary tumor between January 2006 and April 2013 were separated into two groups according to whether or not they had undergone surgery. The difference in characteristics between the two groups was analyzed using chi-square test, Fisher’s exact test and Mann-Whitney test. Univariable and multivariable Cox regression and stratified survival analysis were used to assess the effect of surgery on survival. Results Of the 313 patients, 188 (60.1%) underwent local surgery. Patients with local surgery had a 47% reduction in mortality risk vs. those with no surgery (median survival 78 months vs. 37 months; HR = 0.53; 95% CI, 0.36–0.78) after adjustment for clinical and tumor characteristics. Stratified survival analysis showed that patients with bone metastasis alone (and primary tumor ≤5 cm), soft tissue metastasis, or ≤ 3 metastasis sites benefit from surgery. Conclusion Surgical resection of the primary tumor can improve survival in selected de novo stage IV breast cancer patients.
Databáze: OpenAIRE
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