Better survival after surgery of the primary tumor in stage IV inflammatory breast cancer

被引:15
作者
van Uden, D. J. P. [8 ]
van Maaren, M. C. [2 ,3 ]
Strobbe, L. J. A. [1 ]
Bult, P. [4 ]
Stam, M. R. [5 ]
van der Hoeven, J. J. [6 ]
Siesling, S. [2 ,3 ]
de Wilt, J. H. W. [7 ]
Blanken-Peeters, C. F. J. M. [8 ]
机构
[1] Canisius Wilhelmina Hosp, Dept Surg, Weg Door Jonkerbos 100, NL-6532 SZ Nijmegen, Netherlands
[2] Netherlands Comprehens Canc Org IKNL, Dept Res & Dev, Godebaldkwartier 419, NL-3511 DT Utrecht, Netherlands
[3] Univ Twente, Tech Med Ctr, Dept Hlth Technol & Serv Res, Drienerlolaan 5, NL-7522 NB Enschede, Netherlands
[4] Radboud Univ Nijmegen, Dept Pathol, Med Ctr Nijmegen, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands
[5] Radiotherapy Grp, Wagnerlaan 47, NL-6815 AD Arnhem, Netherlands
[6] Radboud Univ Nijmegen, Dept Med Oncol, Med Ctr Nijmegen, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands
[7] Radboud Univ Nijmegen, Dept Surg Oncol, Med Ctr Nijmegen, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands
[8] Rijnstate Hosp, Dept Surg, Wagnerlaan 55, NL-6815 AD Arnhem, Netherlands
来源
SURGICAL ONCOLOGY-OXFORD | 2020年 / 33卷
关键词
Inflammatory breast cancer; Stage IV; Surgery; RESECTION; IMPACT;
D O I
10.1016/j.suronc.2020.01.005
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction: Information regarding the effects of resection of the primary tumor in stage IV inflammatory breast cancer (IBC) is scarce. We analyzed the impact of resection of the primary tumor on overall survival (OS) in a large stage IV IBC population. Materials and methods: Patients diagnosed with stage IV IBC between 2005 and 2016 were selected from the Netherlands Cancer Registry, excluding patients without any treatment. To correct for immortal time bias, we performed a landmark analysis including patients alive at least six months after diagnosis. With propensity score matching, patients undergoing surgery of the primary tumor were matched to patients not receiving surgery. Multivariable Cox proportional hazard analyses were performed to determine the association between treatment strategy and OS in the non-matched and matched cohort. Results: Of the 580 included patients after landmark analysis, 441 patients (76%) received only non-surgical treatments and 139 (24%) underwent surgery (96% mastectomy). Median follow-up was 28.8 and 20.0 months in the surgery and no surgery group, respectively. Surgery in the non-matched cohort was independently associated with better survival (HR0.56[95%Cb0.42-0.75]). In the matched cohort (n = 202), surgically treated patients had improved survival over nonsurgically treated patients (p < 0.005). Multivariable analysis of the matched cohort revealed that surgery was still associated with better survival (HR0.62[95%Cb0.44-0.87]). Conclusion: Although residual confounding and confounding by severity cannot be ruled out, this study suggests that surgery of the primary tumor is associated with improved OS and should be considered as part of the treatment strategy in stage IV IBC.
引用
收藏
页码:43 / 50
页数:8
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