De novo stage IV BC: local surgery improves survival in Chinese study

  • Xiong Z & al.
  • BMC Cancer
  • 11 Sep 2018

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Surgical resection of the primary tumor in women presenting with stage IV breast cancer (BC) is typically recommended only for palliative treatment.
  • This retrospective study found that surgical resection is also associated with 47% lower mortality.

Why this matters

  • Surgical resection of the primary tumor in de novo stage IV BC should be considered for its survival benefits.

Study design

  • Retrospective cohort of 313 women presenting with stage IV BC, of whom 60.1% underwent surgical resection of the primary tumor (usually modified radical mastectomy).
  • Survival was compared between surgery and nonsurgery groups.
  • Funding: None.

Key results

  • The surgery group had longer median survival (78 months vs 37 months for the nonsurgery group); the mortality risk was cut by 47% after adjustment for clinical and tumor characteristics (adjusted HR, 0.53; 95% CI, 0.36-0.78).
  • In stratified survival analysis, the following subsets of surgery patients had lower mortality:
    • Bone metastasis only and primary tumor ≤5 cm (HR, 0.27; 95% CI, 0.08-0.90).
    • Soft tissue metastasis only (HR, 0.21; 95% CI, 0.06-0.72).
    • ≤3 metastatic sites (HR, 0.54; 95% CI, 0.36-0.81).

Limitations

  • Single-center study.
  • Retrospective, nonrandomized design.

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