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Survival benefit of a combined surgical approach in patients with metastatic breast cancer
Background We previously reported survival benefit of surgery in patients with stage IV breast cancer (BC); prospective trials yielded inconclusive results. Methods We sampled the National Cancer Database (2004–2016) for de novo stage IV BC patients undergoing both primary site resection and metasta...
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Published in: | Journal of surgical oncology 2021-12, Vol.124 (8), p.1235-1241 |
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container_title | Journal of surgical oncology |
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creator | Bilani, Nadeem Yaghi, Marita Singh Jabbal, Iktej Elson, Leah Elimimian, Elizabeth Blessing Liang, Hong Nahleh, Zeina |
description | Background
We previously reported survival benefit of surgery in patients with stage IV breast cancer (BC); prospective trials yielded inconclusive results.
Methods
We sampled the National Cancer Database (2004–2016) for de novo stage IV BC patients undergoing both primary site resection and metastasectomy. A multivariate Cox‐regression survival model investigated the overall survival (OS) of this surgical approach as compared to lumpectomy/mastectomy alone, metastasectomy alone, or no surgery. The Kaplan–Meier method was used to demonstrate the utility of surgery when metastasis were confined to 1 site stratifying by tissue type.
Results
A total of n = 55,125 patients were included. As compared to lumpectomy/mastectomy alone (43 months), lumpectomy/mastectomy + metastasectomy exhibited the best OS (50 months, p = 0.012), metastasectomy alone showed slightly worse OS (30 months, p |
doi_str_mv | 10.1002/jso.26656 |
format | article |
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We previously reported survival benefit of surgery in patients with stage IV breast cancer (BC); prospective trials yielded inconclusive results.
Methods
We sampled the National Cancer Database (2004–2016) for de novo stage IV BC patients undergoing both primary site resection and metastasectomy. A multivariate Cox‐regression survival model investigated the overall survival (OS) of this surgical approach as compared to lumpectomy/mastectomy alone, metastasectomy alone, or no surgery. The Kaplan–Meier method was used to demonstrate the utility of surgery when metastasis were confined to 1 site stratifying by tissue type.
Results
A total of n = 55,125 patients were included. As compared to lumpectomy/mastectomy alone (43 months), lumpectomy/mastectomy + metastasectomy exhibited the best OS (50 months, p = 0.012), metastasectomy alone showed slightly worse OS (30 months, p < 0.0001), and no surgery had the worst OS (21 months, p < 0.0001). In metastasis confined to 1 site, superior OS with combined lumpectomy/mastectomy and metastasectomy versus lumpectomy/mastectomy alone was observed with liver (72.8 vs. 48.1 months, p < 0.001) or lung (49.2 vs. 36.8 months, p < 0.001) metastasis but not bone (52.2 vs. 49.9 months, p < 0.001) or brain (16.2 vs. 15.5 months, p < 0.001).
Conclusion
Patients with metastatic BC undergoing primary site resection and metastasectomy exhibited optimal OS, particularly when metastasis involved only the liver or lung.]]></description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.26656</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc</publisher><subject>Breast cancer ; breast neoplasms ; Lumpectomy ; Mastectomy ; medical oncology ; metastasectomy ; Metastasis ; registries ; Surgery</subject><ispartof>Journal of surgical oncology, 2021-12, Vol.124 (8), p.1235-1241</ispartof><rights>2021 Wiley Periodicals LLC</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3306-d22c675c18714007ef7a26c60674c13c31fab3af091a2af2bb80f2ebe8da5c9b3</citedby><cites>FETCH-LOGICAL-c3306-d22c675c18714007ef7a26c60674c13c31fab3af091a2af2bb80f2ebe8da5c9b3</cites><orcidid>0000-0001-5818-7558 ; 0000-0002-7335-9319 ; 0000-0002-2489-1501</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Bilani, Nadeem</creatorcontrib><creatorcontrib>Yaghi, Marita</creatorcontrib><creatorcontrib>Singh Jabbal, Iktej</creatorcontrib><creatorcontrib>Elson, Leah</creatorcontrib><creatorcontrib>Elimimian, Elizabeth Blessing</creatorcontrib><creatorcontrib>Liang, Hong</creatorcontrib><creatorcontrib>Nahleh, Zeina</creatorcontrib><title>Survival benefit of a combined surgical approach in patients with metastatic breast cancer</title><title>Journal of surgical oncology</title><description><![CDATA[Background
We previously reported survival benefit of surgery in patients with stage IV breast cancer (BC); prospective trials yielded inconclusive results.
Methods
We sampled the National Cancer Database (2004–2016) for de novo stage IV BC patients undergoing both primary site resection and metastasectomy. A multivariate Cox‐regression survival model investigated the overall survival (OS) of this surgical approach as compared to lumpectomy/mastectomy alone, metastasectomy alone, or no surgery. The Kaplan–Meier method was used to demonstrate the utility of surgery when metastasis were confined to 1 site stratifying by tissue type.
Results
A total of n = 55,125 patients were included. As compared to lumpectomy/mastectomy alone (43 months), lumpectomy/mastectomy + metastasectomy exhibited the best OS (50 months, p = 0.012), metastasectomy alone showed slightly worse OS (30 months, p < 0.0001), and no surgery had the worst OS (21 months, p < 0.0001). In metastasis confined to 1 site, superior OS with combined lumpectomy/mastectomy and metastasectomy versus lumpectomy/mastectomy alone was observed with liver (72.8 vs. 48.1 months, p < 0.001) or lung (49.2 vs. 36.8 months, p < 0.001) metastasis but not bone (52.2 vs. 49.9 months, p < 0.001) or brain (16.2 vs. 15.5 months, p < 0.001).
Conclusion
Patients with metastatic BC undergoing primary site resection and metastasectomy exhibited optimal OS, particularly when metastasis involved only the liver or lung.]]></description><subject>Breast cancer</subject><subject>breast neoplasms</subject><subject>Lumpectomy</subject><subject>Mastectomy</subject><subject>medical oncology</subject><subject>metastasectomy</subject><subject>Metastasis</subject><subject>registries</subject><subject>Surgery</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10E1LAzEQBuAgCtbqwX8Q8KKHbSfZ3ezmKMVPCj1UL15CkiY2Zb9Mdlv6702tJ8FThswzw_AidE1gQgDodBPaCWUsZydoRICzhAMvT9Eo9miSFRzO0UUIGwDgnGUj9LEc_NZtZYWVaYx1PW4tlli3tXKNWeEw-E-nY1t2nW-lXmPX4E72zjR9wDvXr3Ftehn6-KWx8iaWWMtGG3-Jzqysgrn6fcfo_fHhbfaczBdPL7P7eaLTFFiyolSzItekLEgGUBhbSMo0A1ZkmqQ6JVaqVFrgRFJpqVIlWGqUKVcy11ylY3R73BsP_BpM6EXtgjZVJRvTDkHQnDFIOc1opDd_6KYdfBOvi4pHlWX0oO6OSvs2BG-s6Lyrpd8LAuKQsogpi5-Uo50e7c5VZv8_FK_LxXHiG3m6fsU</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Bilani, Nadeem</creator><creator>Yaghi, Marita</creator><creator>Singh Jabbal, Iktej</creator><creator>Elson, Leah</creator><creator>Elimimian, Elizabeth Blessing</creator><creator>Liang, Hong</creator><creator>Nahleh, Zeina</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5818-7558</orcidid><orcidid>https://orcid.org/0000-0002-7335-9319</orcidid><orcidid>https://orcid.org/0000-0002-2489-1501</orcidid></search><sort><creationdate>20211201</creationdate><title>Survival benefit of a combined surgical approach in patients with metastatic breast cancer</title><author>Bilani, Nadeem ; Yaghi, Marita ; Singh Jabbal, Iktej ; Elson, Leah ; Elimimian, Elizabeth Blessing ; Liang, Hong ; Nahleh, Zeina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3306-d22c675c18714007ef7a26c60674c13c31fab3af091a2af2bb80f2ebe8da5c9b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Breast cancer</topic><topic>breast neoplasms</topic><topic>Lumpectomy</topic><topic>Mastectomy</topic><topic>medical oncology</topic><topic>metastasectomy</topic><topic>Metastasis</topic><topic>registries</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bilani, Nadeem</creatorcontrib><creatorcontrib>Yaghi, Marita</creatorcontrib><creatorcontrib>Singh Jabbal, Iktej</creatorcontrib><creatorcontrib>Elson, Leah</creatorcontrib><creatorcontrib>Elimimian, Elizabeth Blessing</creatorcontrib><creatorcontrib>Liang, Hong</creatorcontrib><creatorcontrib>Nahleh, Zeina</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bilani, Nadeem</au><au>Yaghi, Marita</au><au>Singh Jabbal, Iktej</au><au>Elson, Leah</au><au>Elimimian, Elizabeth Blessing</au><au>Liang, Hong</au><au>Nahleh, Zeina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival benefit of a combined surgical approach in patients with metastatic breast cancer</atitle><jtitle>Journal of surgical oncology</jtitle><date>2021-12-01</date><risdate>2021</risdate><volume>124</volume><issue>8</issue><spage>1235</spage><epage>1241</epage><pages>1235-1241</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract><![CDATA[Background
We previously reported survival benefit of surgery in patients with stage IV breast cancer (BC); prospective trials yielded inconclusive results.
Methods
We sampled the National Cancer Database (2004–2016) for de novo stage IV BC patients undergoing both primary site resection and metastasectomy. A multivariate Cox‐regression survival model investigated the overall survival (OS) of this surgical approach as compared to lumpectomy/mastectomy alone, metastasectomy alone, or no surgery. The Kaplan–Meier method was used to demonstrate the utility of surgery when metastasis were confined to 1 site stratifying by tissue type.
Results
A total of n = 55,125 patients were included. As compared to lumpectomy/mastectomy alone (43 months), lumpectomy/mastectomy + metastasectomy exhibited the best OS (50 months, p = 0.012), metastasectomy alone showed slightly worse OS (30 months, p < 0.0001), and no surgery had the worst OS (21 months, p < 0.0001). In metastasis confined to 1 site, superior OS with combined lumpectomy/mastectomy and metastasectomy versus lumpectomy/mastectomy alone was observed with liver (72.8 vs. 48.1 months, p < 0.001) or lung (49.2 vs. 36.8 months, p < 0.001) metastasis but not bone (52.2 vs. 49.9 months, p < 0.001) or brain (16.2 vs. 15.5 months, p < 0.001).
Conclusion
Patients with metastatic BC undergoing primary site resection and metastasectomy exhibited optimal OS, particularly when metastasis involved only the liver or lung.]]></abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/jso.26656</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-5818-7558</orcidid><orcidid>https://orcid.org/0000-0002-7335-9319</orcidid><orcidid>https://orcid.org/0000-0002-2489-1501</orcidid></addata></record> |
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subjects | Breast cancer breast neoplasms Lumpectomy Mastectomy medical oncology metastasectomy Metastasis registries Surgery |
title | Survival benefit of a combined surgical approach in patients with metastatic breast cancer |
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