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Soo Kyung Ahn, Wonshik Han, Hyeong-Gon Moon, Jong-Han Yu, Eunyoung Ko, Jin Hye Bae, Jun Won Min, Tae-You Kim1, Seock-Ah Im1, Do-Youn Oh1, Sae-Won Han1, Sung Whan Ha2, Eui Kyu Chie2
, Seung Keun Oh, Yeo-Kyu Youn, Sung-Won Kim, Ki-Tae Hwang, Dong-Young Noh
, Seung Keun Oh, Yeo-Kyu Youn, Sung-Won Kim, Ki-Tae Hwang, Dong-Young Noh
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).
Figures and Tables
Figure 1
Unadjusted overall survival by surgery status. Kaplan-Meier survival curves for surgery and non-surgery groups are shown.
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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