Thomas Kolben1, Theresa M Kolben1, Isabelle Himsl2, Tom Degenhardt1, Jutta Engel3, Rachel Wuerstlein1, Sven Mahner1, Nadia Harbeck1, Steffen Kahlert1. 1. Breast Center, Department for Obstetrics and Gynecology and Comprehensive Cancer Center of LMU, University Hospital Munich - Grosshadern, Ludwig-Maximilian University, Munich, Germany, Munich, Germany. 2. Klinikum Dritter Orden, Department for Obstetrics and Gynecology, Munich, Germany, Munich, Germany. 3. Munich Cancer Registry (MCR) of the Munich Cancer Center (MCC), Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilian University, Munich, Germany.
Abstract
BACKGROUND: This study aimed to identify the association of local surgery of the primary tumor in metastatic breast cancer (MBC) patients with overall survival (OS) and prognostic factors. PATIENTS AND METHODS: Patients with primary MBC (1990-2006) were included in our retrospective analysis (n = 236). 83.1% had surgery for the primary tumor. OS was evaluated using Kaplan-Meier estimates. Predictive factors for OS were determined. RESULTS: Median follow-up was 123 months for all patients still alive at the time of analysis. In univariate analysis, patients with surgery of the primary tumor had significantly prolonged OS (28.9 vs. 23.9 months). Within the surgery group, patients with MBC limited to 1 organ system had a better outcome (39.3 vs. 24.9 months), as did asymptomatic patients. Independent risk factors for shorter OS were hormone receptor negativity, symptoms, and involvement of ≥ 1 organ system. CONCLUSION: Patient selection for local therapy was confounded by a more favorable profile and a lesser tumor burden before surgery, which might implicate a bias. Nevertheless, our univariate results indicate that local surgery of the primary tumor in MBC patients could be considered as part of the therapeutic regimen in selected patients. However, larger patient numbers are needed to prove these findings in the multivariate model.
BACKGROUND: This study aimed to identify the association of local surgery of the primary tumor in metastatic breast cancer (MBC) patients with overall survival (OS) and prognostic factors. PATIENTS AND METHODS: Patients with primary MBC (1990-2006) were included in our retrospective analysis (n = 236). 83.1% had surgery for the primary tumor. OS was evaluated using Kaplan-Meier estimates. Predictive factors for OS were determined. RESULTS: Median follow-up was 123 months for all patients still alive at the time of analysis. In univariate analysis, patients with surgery of the primary tumor had significantly prolonged OS (28.9 vs. 23.9 months). Within the surgery group, patients with MBC limited to 1 organ system had a better outcome (39.3 vs. 24.9 months), as did asymptomatic patients. Independent risk factors for shorter OS were hormone receptor negativity, symptoms, and involvement of ≥ 1 organ system. CONCLUSION:Patient selection for local therapy was confounded by a more favorable profile and a lesser tumor burden before surgery, which might implicate a bias. Nevertheless, our univariate results indicate that local surgery of the primary tumor in MBCpatients could be considered as part of the therapeutic regimen in selected patients. However, larger patient numbers are needed to prove these findings in the multivariate model.
Entities:
Keywords:
Local resection; Metastatic breast cancer; Stage IV breast cancer
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