Palliative surgery versus non-surgery of the solitary metastatic lesion in De novo metastatic breast cancer: A SEER based study

作者全名：Yue, Jian; Wang, Jing; Chen, Wei; Yin, Xuedong; Du, Huimin; Wei, Yuxian

作者地址：[Yue, Jian; Yin, Xuedong; Wei, Yuxian] Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Mol Oncol & Epigenet, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Yue, Jian; Yin, Xuedong; Wei, Yuxian] Chongqing Med Univ, Affiliated Hosp 1, Dept Breast & Thyroid Surg, Chongqing, Peoples R China; [Yue, Jian] Gaozhou Peoples Hosp, Dept Breast Surg, Gaozhou, Peoples R China; [Wang, Jing] Anhui Prov Canc Hosp, Dept Head Neck & Breast Surg, Hefei, Peoples R China; [Wang, Jing] Univ Sci & Technol China, Affiliated Hosp USTC 1, Dept Head Neck Breast & Surg, Div Life Sci & Med, Hefei, Anhui, Peoples R China; [Chen, Wei] Chongqing Med Univ, Youyang Hosp, Affiliated Hosp 1, A Branch, Youyang, Peoples R China; [Du, Huimin] Chongqing Med Univ, Dept Oncol, Affiliated Hosp 1, Chongqing, Peoples R China

通信作者：Wei, YX (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Mol Oncol & Epigenet, 1 Youyi Rd, Chongqing 400016, Peoples R China.; Wei, YX (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Breast & Thyroid Surg, Chongqing, Peoples R China.

来源：MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001252260600050

JCR分区：Q2

影响因子：1.3

年份：2024

卷号：103

期号：25

开始页：　

结束页：　

文献类型：Article

关键词：de novo; metastatic breast cancer; palliative surgery; SEER

摘要：This study aimed to evaluate whether palliative surgery for metastatic lesion could provide a survival benefit in metastatic breast cancer (MBC) patients with solitary metastasis. De novo MBC patients with solitary distant lesions were enrolled utilizing the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was conducted to form matched pairs of the surgery group and the non-surgery group. The breast cancer-specific survival (BCSS) and overall survival (OS) outcomes between the 2 groups were compared in the following 3 sample models: the entire cohort of MBC (7665 cases); subgroups of patients with different isolated metastatic organs; and subgroups of patients with different molecular subtypes for each isolated metastatic organ. Compared with the Non-surgery group, the surgery group showed better BCSS and OS before PSM (HR = 0.88, 95% CI = 0.79-0.99, P = .04 and HR = 0.85, 95% CI = 0.76-0.95, P = .006, respectively). After PSM, palliative surgery still provided an OS benefit in patients with brain metastasis and lung metastasis (HR = 0.59, 95% CI = 0.37-0.95, P = .01 and HR = 0.64, 95% CI = 0.45-0.90, P = .02, respectively). Likewise, a better BCSS benefit was also found in the subset of patients with brain metastasis (HR = 0.61, 95% CI = 0.38-1.00, P = .01). Further stratification analysis indicated that patients with the luminal A subtype with brain metastasis have a better BCSS (HR = 0.36, 95% CI = 0.16-0.79, P = .04) and OS (HR = 0.37, 95% CI = 0.18-0.75, P = .03) after undergoing palliative surgery than nonsurgical treatment. Our study originality showed that palliative surgery for metastatic lesion could improve survival prognosis in patients with special single-organ metastasis and specific molecular subtypes. More clinical studies are needed to determine whether palliative surgery should be performed in MBC patients.

基金机构：National Natural Science Foundation of China [82173166, 81472475, 82103414, 31420103915]; Chongqing Medical Scientific Research Project (Joint project of Chongqing Health Commission and Science and Technology Bureau) [2021MSXM033]

基金资助正文：This work was supported by the National Natural Science Foundation of China (no. 82173166, 81472475, 82103414 and 31420103915) and Chongqing Medical Scientific Research Project (Joint project of Chongqing Health Commission and Science and Technology Bureau no. 2021MSXM033).