Loco-regional treatment in metastatic breast cancer patients: is there a survival benefit?

Ly, Bevan H.; Nguyen, Nam; Vinh Hung, Vincent; Rapiti Aylward, Elisabetta; Vlastos, Georges

doi:10.1007/s10549-009-0610-z

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Title		Loco-regional treatment in metastatic breast cancer patients: is there a survival benefit?
Authors		Ly, Bevan H. Nguyen, Nam Vinh Hung, Vincent Rapiti Aylward, Elisabetta Vlastos, Georges
Published in		Breast Cancer Research and Treatment. 2010, vol. 119, no. 3, p. 537-545
Abstract		A number of studies have recently demonstrated a survival benefit in stage IV breast cancer patients following surgical resection of the primary tumor. Here, we investigate the relationship between loco-regional treatment and survival in patients with metastatic breast cancer and evaluate the impact of different loco-regional treatments. We conducted a systematic review of the literature using PubMed to analyze studies with the following criteria: Type of loco-regional treatment (surgery alone or combined with radiation, radiotherapy), overall survival, progression-free survival, selection factors for local treatment, and complication rates. Thirteen studies evaluated the effect of loco-regional treatment on overall survival with overall median survival increasing from a range of 12.6-28.3 months among patients without surgery to a range of 25-42 months among patients with surgery. In addition, six studies reported a 3-year survival benefit of 28-95% and 17-79% in women with and without locoregional therapy respectively. Two studies did not find any improvement in overall survival. One study found an improvement in 5-year breast cancer-specific survival of 27% with negative surgical margins versus 12% with no surgery. Three studies reported an advantage in progression-free survival in the treatment group compared with the non-treatment group. Loco-regional treatment for breast cancer patients with distant metastases at diagnosis is an important issue because of possible improvement of survival or disease-free survival. The possibility of surgery and/or radiotherapy following induction chemotherapy should be weighed and left to individual practice. Participation in randomized controlled trials should be encouraged.
Keywords		Breast Neoplasms/mortality/pathology/therapy — Combined Modality Therapy — Disease-Free Survival — Female — Humans — Mastectomy — Neoplasm Staging — Radiotherapy — Randomized Controlled Trials as Topic — Risk Factors
Identifiers		DOI: 10.1007/s10549-009-0610-z PMID: 19876731
Full text		Article - Limited access to UNIGE Other version: http://www.springerlink.com/content/67062465x3145j63/fulltext.pdf
Structures		Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires
Research group		Groupe Bouchardy Magnin Christine (Registre genevois des tumeurs) (532)
Citation (ISO format)		LY, Bevan H. et al. Loco-regional treatment in metastatic breast cancer patients: is there a survival benefit?. In: Breast Cancer Research and Treatment, 2010, vol. 119, n° 3, p. 537-545. doi: 10.1007/s10549-009-0610-z https://archive-ouverte.unige.ch/unige:21100