4.7 Article

Clinical Evidence for Locoregional Surgery of the Primary Tumor in Patients with De Novo Stage IV Breast Cancer

期刊

ANNALS OF SURGICAL ONCOLOGY
卷 28, 期 9, 页码 5059-5070

出版社

SPRINGER
DOI: 10.1245/s10434-021-09650-3

关键词

-

资金

  1. National Science and Technology Major Project [2020ZX09201021]
  2. Medical Artificial Intelligence Project of Sun Yat-Sen Memorial Hospital [YXRGZN201902]
  3. National Natural Science Foundation of China [81572596, 81972471, U1601223, 82073408, 81802656, 82071754]
  4. Natural Science Foundation of Guangdong Province [2017A030313828]
  5. Guangzhou Science and Technology Major Program [201704020131]
  6. Guangdong Science and Technology Department [2017B030314026]
  7. Sun Yat-Sen University Clinical Research 5010 Program [2018007]
  8. Sun Yat-Sen Clinical Research Cultivating Program [SYS-C-201801]

向作者/读者索取更多资源

This study found that locoregional surgery did not improve overall survival compared to no surgery in de novo stage IV breast cancer patients, but it did result in longer locoregional progression-free survival. Patients with bone-only metastasis tended to benefit from surgery in terms of overall survival.
Background Whether primary tumor surgery is better than no surgery in patients with de novo stage IV breast cancer remains controversial. Methods This study combined prospective clinical trials and a multicenter cohort to evaluate the impact of locoregional surgery in de novo stage IV breast cancer. The GRADE approach was used to assess the quality of evidence in meta-analysis, and propensity score matching analysis was used in the cohort study. This study was registered with PROSPERO CRD42016043766 and ClinicalTrials.gov NCT04456855. Results A total of 1110 patients from six trials and 353 patients from the cohort study were included. The meta-analysis showed that compared with no surgery, locoregional surgery did not prolong overall survival (hazard ratio [HR] = 0.90, P = 0.40; moderate-quality) but had a significantly longer locoregional progression-free survival (HR = 0.23, P < 0.001; moderate-quality). The subgroup analysis of solitary bone-only metastasis (HR = 0.47, P = 0.04; high-quality) resulted in prolonged overall survival. In the cohort study, locoregional surgery showed a survival benefit (HR = 0.63, P = 0.041) before matching, but not (HR = 0.84, P = 0.579) after matching. Patients with bone-only metastasis showed a survival advantage in surgery compared with no surgery before matching (HR = 0.36, P = 0.034) as well as after matching (HR = 0.18, P = 0.017). Conclusions This study indicated that locoregional surgery had a significantly longer locoregional progression-free survival than no surgery in de novo stage IV breast cancer, and patients with bone-only metastasis tended to show an overall survival benefit from surgery.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.7
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据