Factors associated with better survival after surgery in metastatic breast cancer patients

被引：9
作者：
Khadakban D. [1 ]
Gorasia-Khadakban T. [1 ]
Vijaykumar D.K. [2 ]
Pavithran K. [3 ]
Anupama R. [2 ]
机构：
[1] Department of Surgical oncology, Tower 3-0, Hospital building, Amrita Institute of Medical Sciences, Kochi, Kerala, 682041, AIMS lane, Ponekkara
[2] Department of Surgical Oncology, Amrita Institute of Medical Sciences, Kochi, Kerala, 682041, AIMS lane, Ponekkara
[3] Department of Medical Oncology, Amrita Institute of Medical Sciences, Kochi, Kerala, 682041, AIMS lane, Ponekkara
来源：
Indian Journal of Surgical Oncology | 2013年 / 4卷 / 1期
关键词：
Factors; Metastatic breast cancer; Surgery; Survival;
D O I：
10.1007/s13193-012-0204-9
中图分类号：
学科分类号：
摘要：
Women with Metastatic Breast Cancer (MBC) and an intact primary have long been treated with systemic therapy alone. Local therapy is not considered unless for palliative reasons. However, several studies have suggested local treatment in the form of Surgery for the primary improves overall survival in certain groups of MBC patients. We evaluated the factors influencing the outcome in this group of patients. In a retrospective review of our prospective database, we identified the patients who presented with MBC and underwent surgery for primary tumour (2004-2009). Patients' surgical details and clinicopathological factors were reviewed. The overall survival of the MBC patients who underwent surgery was evaluated and compared depending on the various clinicopathological factors. Out of 196 patients with MBC, 48 underwent surgery of the primary tumor during their treatment course. Median overall survival was better in patients with young age (<=40 years), Estrogen receptor(ER) positive tumors (31.4 months vs 21.2 months), single metastatic site vs multiple metastatic sites (43.4 months vs 26.69 months). We also found that patients with low level of suspicion for metastases fared better than those with high level of suspicion (43.4 months vs 20.9 months). Our data analysis suggested that for MBC patients who undergo surgery, survival is significantly worse in patients with pathological T4 lesions and there is a trend towards better survival in younger patients and in those who have ER positive tumour, Her2neu negative tumour, single site of metastases and patients with low level of metastatic suspicion. However these factors need to be evaluated in a randomized trial comparing with patients who have not undergone surgery. © 2012 Indian Association of Surgical Oncology.
引用
收藏
页码：52 / 58
页数：6
相关论文
共 21 条
  • [1] Khan S., Stewart A., Morrow M., Does aggressive local therapy improve survival in metastatic breast cancer?, Surgery, 132, pp. 620-627, (2002)
  • [2] Danna E.A., Sinha P., Gilbert M., Et al., Surgical removal of primary tumor reverses tumor-induced immunosuppression despite the presence of metastatic disease, Cancer Res, 64, pp. 2205-2211, (2004)
  • [3] Weigelt B., Peterse J.L., Van't Veer L.J., Breast cancer metastasis: markers and models, Nat Rev Cancer, 5, 8, pp. 591-602, (2005)
  • [4] Schmidt-Kittler O., Ragg T., Daskalakis A., Et al., From latent disseminated cells to overt metastasis: genetic analysis of systemic breast cancer progression, Proc Natl Acad Sci U S A, 100, 13, pp. 7737-7742, (2003)
  • [5] Lang J.E., Babiera G.V., Locoregional Resection in Stage IV Breast Cancer: Tumor Biology, Molecular and Clinical Perspectives, Surg Clin N Am, 87, pp. 527-538, (2007)
  • [6] Braun S., Vogl F.D., Naume B., Et al., A pooled analysis of bone marrow micrometastasis in breast cancer, N Engl J Med, 353, 8, pp. 793-802, (2005)
  • [7] Carmichael A.R., Anderson E.D., Chetty U., Et al., Does local surgery have a role in the management of Stage IV breast cancer?, Eur J Surg Oncol, 29, 1, pp. 17-19, (2003)
  • [8] Rapiti E., Verkooijen H.M., Vlastos G., Et al., Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis, J Clin Oncol, 24, pp. 2743-2749, (2006)
  • [9] Babiera G.V., Et al., Effect of Primary Tumor Extirpation in Breast Cancer Patients Who Present With Stage IV Disease and an Intact Primary Tumor, Ann Surg Oncol, 13, pp. 776-782, (2006)
  • [10] Gnerlich J., Jeffe D., Deshpane A., Et al., Surgical removal of the primary tumor increases overall survival in patients with metastatic breast cancer: analysis of the 1988-2003 SEER data, Ann Surg Oncol, 14, pp. 2187-2194, (2007)
123