解锁生存益处：初诊IV期乳腺癌患者的原发肿瘤切除术

Unlocking survival benefits: primary tumor resection in de novo stage IV breast cancer patients.

作者信息

Chen Dong, Wang Yue, Pan Yuancan, Zhang Boran, Yao Wentao, Peng Yu, Zhang Ganlin, Wang Xiaomin

机构信息

Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.

Department of Surgery, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Expert Rev Anticancer Ther. 2024 Dec;24(12):1303-1310. doi: 10.1080/14737140.2024.2428695. Epub 2024 Nov 15.

DOI:10.1080/14737140.2024.2428695

PMID:39521623

Abstract

BACKGROUND

For patients with de novo stage IV breast cancer (BC), the conditions under which the primary tumor resection (PTR) may offer benefit remain unclear.

METHODS

The SEER database provides treatment data for patients with de novo stage IV BC. We screened cases of metastatic BC diagnosed from 2010 to 2015, with primary endpoints of overall survival (OS) and cancer-specific survival (CSS).

RESULTS

9252 patients with stage IV de novo BC were enrolled. For OS, median survival time (MST) was 38 months with systematic treatment (ST) compared to 52 months with ST plus PTR ( < 0.001). For CSS, MST was 38 months for ST versus 54 months for ST plus PTR ( < 0.001). The results of the Cox proportional hazards regression analysis regarding PTR, for OS: bone metastasis (aHR 0.664, 95%CI 0.583-0.756, < 0.001); liver-lung metastasis (aHR 0.528, 95%CI 0.327-0.853, = 0.009). For CSS: bone metastasis (aHR 0.655, 95%CI 0.571-0.751, < 0.001); liver-lung metastasis (aHR 0.549, 95%CI 0.336-0.889, = 0.017). Kaplan-Meier analysis indicated that in patients with bone metastases and liver-lung metastases, PTR could improve survival outcomes.

CONCLUSION

Liver-lung metastases and bone metastases in patients with de novo stage IV BC could enhance both OS and CSS through PTR.

摘要

背景

对于初诊为IV期乳腺癌（BC）的患者，原发性肿瘤切除术（PTR）可能带来益处的条件仍不明确。

方法

SEER数据库提供了初诊为IV期BC患者的治疗数据。我们筛选了2010年至2015年诊断为转移性BC的病例，主要终点为总生存期（OS）和癌症特异性生存期（CSS）。

结果

纳入了9252例初诊为IV期BC的患者。对于OS，系统治疗（ST）的中位生存时间（MST）为38个月，而ST加PTR的中位生存时间为52个月（<0.001）。对于CSS，ST的MST为38个月，而ST加PTR的MST为54个月（<0.001）。关于PTR的Cox比例风险回归分析结果，对于OS：骨转移（风险比[HR]0.664，95%置信区间[CI]0.583 - 0.756，<0.001）；肝肺转移（HR 0.528，95%CI 0.327 - 0.853，=0.009）。对于CSS：骨转移（HR 0.655，95%CI 0.571 - 0.751，<0.001）；肝肺转移（HR 0.549，95%CI 0.336 - 0.889，=0.017）。Kaplan-Meier分析表明，在骨转移和肝肺转移患者中，PTR可改善生存结局。