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乳腺癌肺寡转移:治疗策略的前瞻性队列研究(SBP-06)。

Lung Oligometastasis of Breast Cancer: Prospective Cohort Study of Treatment Strategies (SBP-06).

机构信息

Department of Breast and Endocrine Surgery, Okayama University Hospital.

Department of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital.

出版信息

Acta Med Okayama. 2024 Feb;78(1):15-20. doi: 10.18926/AMO/66666.

Abstract

While local treatment of metastases is considered to be unrelated to prognosis, previous studies have suggested that local treatment of isolated lung metastases may have positive prognostic impact. We designed this prospective cohort study to investigate the clinical situation and its outcomes. We enrolled patients with fewer than 3 lung nodules suspected of being oligometastases after curative breast cancer surgery. Treatments, including local and systemic therapy, were selected by the physician and patient in consultation. The primary outcome was overall survival (OS); secondary outcomes were the efficacy and the safety of the surgery for lung oligometastases. Between May 2015 and May 2019, 14 patients were enrolled. Resection of lung nodules (metastasectomy) was performed in 11 (78.6%) of 14 patients, and one of these cases was diagnosed as primary lung cancer. Metastasectomies were all performed employing video-assisted thoracic surgery (VATS) without perioperative complications. Systemic therapies were administered to all patients except one. The respective 3-year and 5-year OS rates of patients with lung oligometastases were 91.6% and 81.5%, respectively. Progression occurred in 6 patients: 3 of the 10 with metastasectomy and all 3 without this surgical procedure. Lung metastasectomy was worthwhile as a diagnostic evaluation and may provide long-term benefit in some patients.

摘要

虽然局部治疗转移灶与预后无关,但先前的研究表明,孤立性肺转移灶的局部治疗可能具有积极的预后影响。我们设计了这项前瞻性队列研究来调查临床情况及其结果。我们招募了在根治性乳腺癌手术后疑似寡转移的少于 3 个肺结节的患者。治疗方法,包括局部和全身治疗,由医生和患者协商选择。主要结局是总生存期(OS);次要结局是肺寡转移灶手术的疗效和安全性。2015 年 5 月至 2019 年 5 月期间,共纳入 14 例患者。14 例患者中有 11 例(78.6%)进行了肺结节切除术(转移切除术),其中 1 例被诊断为原发性肺癌。所有转移切除术均采用电视辅助胸腔镜手术(VATS)进行,无围手术期并发症。除 1 例患者外,所有患者均接受了全身治疗。肺寡转移患者的 3 年和 5 年 OS 率分别为 91.6%和 81.5%。6 例患者出现进展:10 例接受转移切除术的患者中有 3 例,所有 3 例未接受该手术的患者均出现进展。肺转移切除术作为一种诊断评估是有价值的,并且可能为某些患者提供长期获益。

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