Ueno Takayuki
Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Front Oncol. 2022 May 4;12:910544. doi: 10.3389/fonc.2022.910544. eCollection 2022.
Breast cancer with distant metastases is a systemic disease. While systemic therapies are the main treatment strategy, locoregional therapy for metastatic breast cancer (MBC) is generally palliative only. However, recent progress in systemic and local therapies has improved the prognosis of patients with MBC and some may expect long-term survival. More vigorous local therapies for MBC may, therefore, be clinically justified in selected patients. A number of clinical trials and studies have investigated the clinical significance of surgical therapy for primary tumors and distant metastases in patients with MBC. Four prospective randomized trials and multiple retrospective studies have investigated the benefit of surgical resection of primary lesions in patients with MBC, with conflicting results. There have been a number of case-control studies examining the impact of surgical resection of distant metastases, but the benefit of this approach in terms of survival is controversial because selection bias is unavoidable in retrospective studies. The present review discusses the state of the literature relating to local management of the primary breast cancer through surgical resection and surgical management of distant metastatic lesions including pulmonary and liver metastases with future perspectives.
伴有远处转移的乳腺癌是一种全身性疾病。虽然全身治疗是主要的治疗策略，但转移性乳腺癌（MBC）的局部区域治疗通常仅具有姑息性。然而，全身和局部治疗的最新进展改善了MBC患者的预后，一些患者可能期望长期生存。因此，对于部分选定的患者，更积极的MBC局部治疗在临床上可能是合理的。许多临床试验和研究探讨了MBC患者原发性肿瘤和远处转移灶手术治疗的临床意义。四项前瞻性随机试验和多项回顾性研究探讨了MBC患者手术切除原发性病灶的益处，但结果相互矛盾。有多项病例对照研究考察了手术切除远处转移灶的影响，但由于回顾性研究中不可避免地存在选择偏倚，这种方法对生存的益处存在争议。本综述讨论了通过手术切除对原发性乳腺癌进行局部处理以及对包括肺和肝转移在内的远处转移病灶进行手术处理的相关文献现状，并展望了未来前景。
