Atilla Soran1, Lutfi Dogan2, Arda Isik3, Serdar Ozbas4, Didem Can Trabulus5, Umut Demirci6, Hasan Karanlik7, Aykut Soyder8, Ahmet Dag9, Ahmet Bilici10, Mutlu Dogan11, Hande Koksal12, Mehmet Ali Nahit Sendur13, Mehmet Ali Gulcelik14, Gokturk Maralcan15, Neslihan Cabioglu16, Levent Yeniay17, Zafer Utkan18, Turgay Simsek18, Nuri Karadurmus19, Gul Daglar4, Birol Yildiz19, Cihan Uras20, Mustafa Tukenmez16, Ahmet Yildirim11, Suat Kutun2, Cihangir Ozaslan2, Niyazi Karaman21, Müfide Nuran Akcay22, Osman Toktas23, Efe Sezgin24. 1. Division of Surgical Oncology, UPMC (University of Pittsburgh Medical Center) Magee-Womens Hospital, Pittsburgh, USA. asoran@upmc.edu. 2. Department of Surgical Oncology, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey. 3. Department of Surgery, Erzincan Binali Yıldırım University, Erzincan, Turkey. 4. Private, Breast and Endocrine Surgeon, Ankara, Turkey. 5. Department of Surgery, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. 6. Department of Medical Oncology, Memorial Ankara Hospital, University of Uskudar School of Medicine, Istanbul, Turkey. 7. Surgical Oncology Unit, Istanbul University Institute of Oncology, Istanbul, Turkey. 8. Department of Surgery, School of Medicine, Adnan Menderes University, Aydın, Turkey. 9. Department of Surgery, School of Medicine, Mersin University, Mersin, Turkey. 10. Department of Medical Oncology, School of Medicine, Medipol University, Istanbul, Turkey. 11. Department of Medical Oncology, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey. 12. Department of Surgery, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey. 13. Department of Medical Oncology, School of Medicine, Yıldırım Beyazit University, Ankara, Turkey. 14. Department of Surgical Oncology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey. 15. Department of Surgery, School of Medicine, Sanko University, Gaziantep, Turkey. 16. Department of Surgery, School of Medicine Istanbul University, Istanbul, Turkey. 17. Department of Surgery, School of Medicine, Ege University, Izmir, Turkey. 18. Department of Surgery, School of Medicine, Kocaeli University, İzmit, Turkey. 19. Department of Medical Oncology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey. 20. Department of Surgery, Acibadem University School of Medicine, Istanbul, Turkey. 21. Department of Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey. 22. Department of Surgery, School of Medicine, Atatürk University, Erzurum, Turkey. 23. Department of Surgery, School of Medicine, Yuzuncuyıl University, Van, Turkey. 24. Department of Food and Engineering, Faculty of Engineering, Izmir Institute of Technology, Izmir, Turkey.
Abstract
BACKGROUND: More evidence shows that primary surgery for de novo metastatic breast cancer (BC) prolongs overall survival (OS) in selected cases. The aim of this study was to evaluate the role of locoregional treatment (LRT) in BC patients with de novo stage IV bone only metastasis (BOM). METHODS: The prospective, multicenter registry study BOMET MF14-01 was initiated in May 2014. Patients with de novo stage IV BOM BC were divided into two groups: those receiving systemic treatment (ST group) and those receiving LRT (LRT group). Patients who received LRT were further divided into two groups: ST after LRT (LRT + ST group) and ST before LRT (ST + LRT group). RESULTS: We included 505 patients in this study; 240 (47.5%) patients in the ST group and 265 (52.5%) in the LRT group. One hundred and thirteen patients (26.3%) died in the 34-month median follow-up, 85 (35.4%) in the ST group and 28 (10.5%) in LRT group. Local progression was observed in 39 (16.2%) of the patients in the ST group and 18 (6.7%) in the LRT group (p = 0.001). Hazard of death was 60% lower in the LRT group compared with the ST group (HR 0.40, 95% CI 0.30-0.54, p < 0.0001). CONCLUSION: In this prospectively maintained registry study, we found that LRT prolonged survival and decreased locoregional recurrence in the median 3-year follow-up. Timing of primary breast surgery either at diagnosis or after ST provided a survival benefit similar to ST alone in de novo stage IV BOM BC patients.
BACKGROUND: More evidence shows that primary surgery for de novo metastatic breast cancer (BC) prolongs overall survival (OS) in selected cases. The aim of this study was to evaluate the role of locoregional treatment (LRT) in BC patients with de novo stage IV bone only metastasis (BOM). METHODS: The prospective, multicenter registry study BOMET MF14-01 was initiated in May 2014. Patients with de novo stage IV BOM BC were divided into two groups: those receiving systemic treatment (ST group) and those receiving LRT (LRT group). Patients who received LRT were further divided into two groups: ST after LRT (LRT + ST group) and ST before LRT (ST + LRT group). RESULTS: We included 505 patients in this study; 240 (47.5%) patients in the ST group and 265 (52.5%) in the LRT group. One hundred and thirteen patients (26.3%) died in the 34-month median follow-up, 85 (35.4%) in the ST group and 28 (10.5%) in LRT group. Local progression was observed in 39 (16.2%) of the patients in the ST group and 18 (6.7%) in the LRT group (p = 0.001). Hazard of death was 60% lower in the LRT group compared with the ST group (HR 0.40, 95% CI 0.30-0.54, p < 0.0001). CONCLUSION: In this prospectively maintained registry study, we found that LRT prolonged survival and decreased locoregional recurrence in the median 3-year follow-up. Timing of primary breast surgery either at diagnosis or after ST provided a survival benefit similar to ST alone in de novo stage IV BOM BC patients.
Authors: Zoltán Mátrai; Péter Kelemen; Csaba Kósa; Róbert Maráz; Attila Paszt; Gábor Pavlovics; Ákos Sávolt; Zsolt Simonka; Dezső Tóth; Miklós Kásler; Andrey Kaprin; Petr Krivorotko; Ferenc Vicko; Piotr Pluta; Agnieszka Kolacinska-Wow; Dawid Murawa; Jerzy Jankau; Slawomir Ciesla; Daniel Dyttert; Martin Sabol; Andrii Zhygulin; Artur Avetisyan; Alexander Bessonov; György Lázár Journal: Pathol Oncol Res Date: 2022-06-15 Impact factor: 2.874