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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2021

01-09-2021 | Breast Surgery | Breast Oncology

The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multi-Center, Prospective Registry Study

Authors: Atilla Soran, MD, MPH, FNCBC, FACS, Lutfi Dogan, MD, Arda Isik, MD, Serdar Ozbas, MD, Didem Can Trabulus, MD, Umut Demirci, MD, Hasan Karanlik, MD, Aykut Soyder, MD, Ahmet Dag, MD, Ahmet Bilici, MD, Mutlu Dogan, MD, Hande Koksal, MD, Mehmet Ali Nahit Sendur, MD, Mehmet Ali Gulcelik, MD, Gokturk Maralcan, MD, Neslihan Cabioglu, MD, PhD, Levent Yeniay, MD, Zafer Utkan, MD, Turgay Simsek, MD, Nuri Karadurmus, MD, Gul Daglar, MD, Birol Yildiz, MD, Cihan Uras, MD, Mustafa Tukenmez, MD, Ahmet Yildirim, MD, Suat Kutun, MD, Cihangir Ozaslan, MD, Niyazi Karaman, MD, Müfide Nuran Akcay, MD, Osman Toktas, MD, Efe Sezgin, PhD

Published in: Annals of Surgical Oncology | Issue 9/2021

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Abstract

Background

More evidence shows that primary surgery for de novo metastatic breast cancer (BC) prolongs overall survival (OS) in selected cases. The aim of this study was to evaluate the role of locoregional treatment (LRT) in BC patients with de novo stage IV bone only metastasis (BOM).

Methods

The prospective, multicenter registry study BOMET MF14-01 was initiated in May 2014. Patients with de novo stage IV BOM BC were divided into two groups: those receiving systemic treatment (ST group) and those receiving LRT (LRT group). Patients who received LRT were further divided into two groups: ST after LRT (LRT + ST group) and ST before LRT (ST + LRT group).

Results

We included 505 patients in this study; 240 (47.5%) patients in the ST group and 265 (52.5%) in the LRT group. One hundred and thirteen patients (26.3%) died in the 34-month median follow-up, 85 (35.4%) in the ST group and 28 (10.5%) in LRT group. Local progression was observed in 39 (16.2%) of the patients in the ST group and 18 (6.7%) in the LRT group (p = 0.001). Hazard of death was 60% lower in the LRT group compared with the ST group (HR 0.40, 95% CI 0.30–0.54, p < 0.0001).

Conclusion

In this prospectively maintained registry study, we found that LRT prolonged survival and decreased locoregional recurrence in the median 3-year follow-up. Timing of primary breast surgery either at diagnosis or after ST provided a survival benefit similar to ST alone in de novo stage IV BOM BC patients.
Literature
1.
Hellman S. Natural history of small breast cancers. J Clin Oncol. 1994;12:2229–34.CrossRef
2.
Andre F, Slimane K, Bachelot T, et al. Breast cancer with synchronous metastases: trends in survival during a 14-year period. J Clin Oncol. 2004;22:3302–8.CrossRef
3.
Gnerlich J, Jeffe DB, Deshpande AD, et al. Surgical removal of the primary tumor increases overall survival in patients with metastatic breast cancer: analysis of the 1988–2003 SEER data. Ann Surg Oncol. 2007;14:2187–94.CrossRef
4.
Babiera GV, Rao R, Feng L, et al. Effect of primary tumor extirpation in breast cancer patients who present with stage IV disease and an intact primary tumor. Ann Surg Oncol. 2006;13:776–82.CrossRef
5.
Pérez-Fidalgo JA, Pimentel P, Caballero A, et al. Removal of primary tumor improves survival in metastatic breast cancer. Does timing of surgery influence outcomes? Breast. 2011;20:548–54.CrossRef
6.
Leung AM, Vu HN, Nguyen KA, et al. Effects of surgical excision on survival of patients with stage IV breast cancer. J Surg Res. 2010;161:83–8.CrossRef
7.
Pathy NB, Verkooijen HM, Taib NA, et al. Impact of breast surgery on survival in women presenting with metastatic breast cancer. Br J Surg. 2011;98:1566–72.CrossRef
8.
Bafford AC, Burstein HJ, Barkley CR, et al. Breast surgery in stage IV breast cancer: impact of staging and patient selection on overall survival. Breast Cancer Res Treat. 2009;115:7–12.CrossRef
9.
Fields RC, Jeffe DB, Trinkaus K, et al. Surgical resection of the primary tumor is associated with increased long-term survival in patients with stage IV breast cancer after controlling for site of metastasis. Ann Surg Oncol. 2007;14:3345–51.CrossRef
10.
Harris E, Mitchel B, Kell MR. Meta-analysis to determine if surgical resection of the primary tumour in the setting of stage IV breast cancer impacts on survival. Ann Surg Oncol. 2013;20:2828–34.CrossRef
11.
Petrelli F, Barni S. Surgery of primary tumors in stage IV breast cancer: an updated meta-analysis of published studies with meta-regression. Med Oncol. 2012;29:3282–90.CrossRef
12.
Cady B, Nathan NR, Michaelson JS, et al. Matched pair analyses of stage IV breast cancer with or without resection of primary breast site. Ann Surg Oncol. 2008;15:3384–95.CrossRef
13.
Soran A, Ozmen V, Ozbas S, et al. Randomized trial comparing resection of primary tumor with no surgery in stage iv breast cancer at presentation: protocol MF07-01. Ann Surg Oncol. 2018;25:3141–9.CrossRef
14.
Noone AMHN, Krapcho M, Miller D, et al. editors. SEER cancer statistics review, 1975–2015: National Cancer Institute; 2018.
15.
Howlader NNA, Krapcho M. SEER Fast Stats, 1975-2014. Stage Distrib 2018: 2005–14.
16.
Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12:6243–9.CrossRef
17.
Wang K, Shi Y, Li ZY, et al. Metastatic pattern discriminates survival benefit of primary surgery for de novo stage IV breast cancer: a real-world observational study. Eur J Surg Oncol. 2019;45:1364–72.CrossRef
18.
Badwe R, Hawaldar R, Nair N, et al. Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial. Lancet Oncol. 2015;16:1380–8.CrossRef
19.
Khan SA, Zhao F, Solin JL, et al. A randomized phase III trial of systemic therapy plus early local therapy versus systemic therapy alone in women with de novo stage IV breast cancer: a trial of the ECOG-ACRIN Research Group (E2108). J Clin Oncol. 2020;38(Suppl 18):1000–6.
20.
Gera R, Chehade HELH, Wazir U, et al. Locoregional therapy of the primary tumour in de novo stage IV breast cancer in 216066 patients: a meta-analysis. Sci Rep. 2020;19(10):2952.CrossRef
21.
Vohra NA, Brinkley J, Kachare S, Muzaffar M. Primary tumor resection in metastatic breast cancer: a propensity-matched analysis, 1988–2011 SEER database. Breast J. 2018;24:549–54.CrossRef
22.
Xiao W, Zou Y, Zheng S, et al. Primary tumor resection in stage IV breast cancer: a systematic review and meta-analysis. Eur J Surg Oncol. 2018;44:1504–12.CrossRef
23.
Mugdway R, Villanueva C, Lin AC, et al. The impact of primary tumor surgery on survival in HER2 positive stage IV breast cancer patients in the current era of targeted therapy. Ann Surg Oncol. 2020;27:2711–20.CrossRef
24.
Pons-Tostivint E, Kirova Y, Lusque A, et al. Survival impact of locoregional treatment of the primary tumor in de novo metastatic breast cancers in a large multicentric cohort study: a propensity score-matched analysis. Ann Surg Oncol. 2019;26:356–65.CrossRef
25.
Li X, Huang R, Ma L, et al. Locoregional surgical treatment improves the prognosis in primary metastatic breast cancer patients with a single distant metastasis except for brain metastasis. Breast. 2019;45:104–12.CrossRef
26.
Co M, Ng J, Kwong A, et al. De-novo metastatic breast cancers with or without primary tumor resection—a 10-year study. Cancer Treat Res Commun. 2019;19:1001–18.
27.
Si Y, Yuan P, Hu N, et al. Primary tumor surgery for patients with de novo stage IV breast cancer can decrease local symptoms and improve quality of life. Ann Surg Oncol. 2020;27:1025–33.CrossRef
Metadata
Title
The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multi-Center, Prospective Registry Study
Authors
Atilla Soran, MD, MPH, FNCBC, FACS
Lutfi Dogan, MD
Arda Isik, MD
Serdar Ozbas, MD
Didem Can Trabulus, MD
Umut Demirci, MD
Hasan Karanlik, MD
Aykut Soyder, MD
Ahmet Dag, MD
Ahmet Bilici, MD
Mutlu Dogan, MD
Hande Koksal, MD
Mehmet Ali Nahit Sendur, MD
Mehmet Ali Gulcelik, MD
Gokturk Maralcan, MD
Neslihan Cabioglu, MD, PhD
Levent Yeniay, MD
Zafer Utkan, MD
Turgay Simsek, MD
Nuri Karadurmus, MD
Gul Daglar, MD
Birol Yildiz, MD
Cihan Uras, MD
Mustafa Tukenmez, MD
Ahmet Yildirim, MD
Suat Kutun, MD
Cihangir Ozaslan, MD
Niyazi Karaman, MD
Müfide Nuran Akcay, MD
Osman Toktas, MD
Efe Sezgin, PhD
Publication date
01-09-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-09621-8

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