Therapeutic Role of Locoregional Surgery in Patients with Stage IV Breast Cancer

Abstract

Objective : The purpose of this retrospective study was to investigate whether loco-regional surgery (LRS) improved survival in patients with stage IV breast cancer.

Subjects and methods : This study cohort comprised 51 women referred to our hospital with diagnosed clinical stage IV breast cancer between 2001 and 2014. Based on the treatment, the patients were grouped into the following three groups : group A comprising 11 (22%) patients who underwent initial LRS followed by systemic therapy, group B comprising 24 (47%) who received initial systemic therapy followed by LRS, and group C comprising 16 (31%) who received systemic therapy alone. Their treatments, clinicopathological characteristics and overall survival were compared among the three groups.

Results : Median survival times of the three groups were 27.2 months (group A), 37.8 months (group B), and 29.3 months (group C). There was no significant difference among the three groups (logrank p=0.89). Median follow-up time was 60 months, and 10/51(19.6%) patients remained alive. In a multivariate analysis, triple negative type (p=0.01) and visceral metastases (p=0.0001) were independent poor prognostic factors, and success in the initial systemic therapy was a good prognostic factor associated with survival. LPS showed no significant difference.

Conclusions : LPS for stage IV breast cancer did not influence overall survival. By considering prognostic factors for reference, we should carefully select surgical adaptation.