Metastatic pattern discriminates survival benefit of primary surgery for de novo stage IV breast cancer: A real-world observational study

Role of surgery in the management of de novo stage IV breast cancer (BC) remains controversial. We aimed to determine the survival benefit of primary surgery on the basis of metastatic pattern. A retrospective cohort study based on the SEER database was conducted to identify patients with de novo st...

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Bibliographic Details
Published in:European journal of surgical oncology 2019-08, Vol.45 (8), p.1364-1372
Main Authors: Wang, Kang, Shi, Yang, Li, Zhu-Yue, Xiao, Ye-Lei, Li, Jie, Zhang, Xiang, Li, Hong-Yuan
Format: Article
Language:English
Subjects:
de novo stage IV breast cancer
Metastatic pattern
Primary surgery
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Summary:Role of surgery in the management of de novo stage IV breast cancer (BC) remains controversial. We aimed to determine the survival benefit of primary surgery on the basis of metastatic pattern. A retrospective cohort study based on the SEER database was conducted to identify patients with de novo stage IV BC diagnosed between 2010 and 2015. Patients were divided into surgery and non-surgery group, and propensity score weighting was used to balance clinicopathologic factors between groups. Of 8142 de novo stage IV BC patients, 1891 (23%) cases were managed with surgery and 6251 (77%) cases were managed without surgery. There were 3821 all-cause deaths and 3291 BC specific deaths over a median follow-up of 22 months. The weighted 3-year overall survival (OS) for the surgery group was 54.5%, compared to 47.7% (P 
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2019.02.013