J Breast Cancer.  2010 Mar;13(1):90-95. 10.4048/jbc.2010.13.1.90.

The Impact of Primary Tumor Resection on the Survival of Patients with Stage IV Breast Cancer

• Ahn SK
• Han W
• Moon HG
• Yu JH
• Ko E
• Bae JH
• Min JW
• Kim TY
• Im SA
• Oh DY
• Han SW
• Ha SW
• Chie EK
• Oh SK
• Youn YK
• Kim SW
• Hwang KT
• Noh DY

• KMID: 2286565
• DOI: http://doi.org/10.4048/jbc.2010.13.1.90

Abstract

PURPOSE
The main treatment for stage IV breast cancer is currently systemic therapy. Surgical resection of the primary tumor is usually done for treating the tumor-related complications. Recent studies have suggested that surgery may improve the long-term survival of stage IV breast cancer patients. We evaluated the impact of the primary surgical resection site on the survival of stage IV breast cancer patients.
METHODS
We reviewed the records of the stage IV breast cancer patients who were treated at Seoul University Hospital between April 1992 and December 2007. The tumor and clinical characteristics, the type of treatments and the overall survival were compared between the surgically versus nonsurgically treated patients.
RESULTS
Of the 198 identified patients, 110 (55.8%) received surgical excision of their primary tumor and 88 (44.2%) did not. The mean survival was 67 months vs. 42 months for the surgically treated patients vs. the patients without surgery, respectively (p=0.0287). On a multivariate analysis with using the Cox model and after adjusting for the estrogen receptor status, visceral metastases, the number of metastatic sites and trastuzumab treatment, surgery was an independent factor for improved survival (hazard ratio, 0.55; 95% confidence interval, 0.31-0.97; p=0.041).
CONCLUSION
Surgical resection of the primary tumor in stage IV breast cancer patients was independently associated with improved survival. Randomized prospective trials are needed to firmly recommend surgical resection of the primary tumor in stage IV breast cancer patients.

Keyword

Breast neoplasms; Neoplasm metastasis; Stage IV; Surgery; Survival

MeSH Terms

Antibodies, Monoclonal, Humanized
Breast
Breast Neoplasms
Estrogens
Humans
Multivariate Analysis
Neoplasm Metastasis
Trastuzumab
Antibodies, Monoclonal, Humanized
Estrogens

Figure

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  Figure 1 Unadjusted overall survival by surgery status. Kaplan-Meier survival curves for surgery and non-surgery groups are shown.

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  Figure 2 Adjusted overall survival by surgery status. Survival curves are derived from Cox model, adjusted for surgery status, estrogen receptor, visceral metastases, number of metastatic sites and trastuzumab treatment.

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