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

Journal Article · Fri Feb 15 04:00:00 EST 2019 · Annals of Surgical Oncology (Online)

DOI:https://doi.org/10.1245/S10434-018-6831-9· OSTI ID:22927890

Pons-Tostivint, Elvire ^[1]; Kirova, Youlia ^[2]; Lusque, Amélie ^[3]; Campone, Mario ^[4]; Geffrelot, Julien ^[5]; Mazouni, Chafika ^[6]; Mailliez, Audrey ^[7]; Pasquier, David ^[8]; Madranges, Nicolas ^[9]; Firmin, Nelly ^[10]; Crouzet, Agathe ^[11]; Gonçalves, Anthony ^[12]; Jankowski, Clémentine ^[13]; Pouget, Nicolas ^[14]; Lande, Brigitte de La ^[15]; Mouttet-Boizat, Delphine ^[16]; Ferrero, Jean-Marc ^[17]; others, and

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1. IUCT-Oncopole, Department of Medical Oncology, Claudius Regaud Institute (France)
2. Curie Institute, Department of Radiation Oncology (France)
3. IUCT-Oncopole, Department of Biostatistics, Claudius Regaud Institute (France)
4. Institut de Cancérologie de l’Ouest (ICO), Department of Medical Oncology, René Gauducheau Center (France)
5. François Baclesse Center, Department of Radiation Oncology (France)
6. Gustave Roussy Institute, Department of Surgery (France)
7. Oscar Lambret Center, Department of Medical Oncology (France)
8. Oscar Lambret Center, Department of Radiation Oncology (France)
9. Bergonié Institute, Department of Medical Oncology (France)
10. Institut du Cancer de Montpellier, Department of Medical Oncology (France)
11. Henri Becquerel Center, Department of Surgery (France)
12. Paoli-Calmettes Institute, Department of Medical Oncology (France)
13. Georges-François Leclerc Center, Department of Surgery (France)
14. Curie Institute, Department of Surgery, René Huguenin Centre (France)
15. Curie Institute, Department of Radiation Oncology, René Huguenin Centre (France)
16. Curie Institute, Department of Surgery (France)
17. Antoine Lacassagne Cancer Center, Department of Medical Oncology (France)

Introduction: Improvement in overall survival (OS) by locoregional treatment (LRT) of the primary tumor in de novo metastatic breast cancer (MBC) patients remains controversial. Objective: The aim of our study was to evaluate the impact of LRT on OS in a large retrospective cohort of de novo MBC patients, with regard to immunohistochemical characteristics and pattern of metastatic dissemination. Methods: We conducted a multicentric retrospective study of patients diagnosed with de novo MBC selected from the French Epidemiological Strategy and Medical Economics MBC database (NCT03275311) between 2008 and 2014. Overall, 4276 women were included in the study. LRT comprised either radiotherapy, surgery, or both. Results: LRT was used in 40% of patients. Compared with no LRT, patients who received LRT were younger (p < 0.0001) and were more likely to have only one metastatic site (p < 0.0001) or bone-only metastases (p < 0.0001). LRT was associated with a significantly better OS based on landmark multivariate analysis at 1-year (hazard ratio 0.65, 95% confidence interval 0.55–0.76, p < 0.001). Similar results were observed in all sensitivity analyses, including propensity score matching. In subgroup analysis, LRT was associated with better OS in patients with hormone receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative (61.6 vs. 45.9 months, p < 0.001) and HER2-positive tumors (77.2 vs. 52.6 months, p = 0.008), but not in triple-negative tumors (19 vs. 18.6 months, p = 0.54), and was also associated with a reduction in the risk of death in visceral metastatic patients (p < 0.001). Conclusions: LRT was associated with a significantly better OS in de novo MBC patients, including patients with visceral involvement at diagnosis; however, LRT did not impact OS in triple-negative MBC.

• OSTI ID: 22927890
• Journal Information: Annals of Surgical Oncology (Online), Journal Name: Annals of Surgical Oncology (Online) Journal Issue: 2 Vol. 26; ISSN 1534-4681
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DIAGNOSIS
HORMONES
MAMMARY GLANDS
METASTASES
NEOPLASMS
PATIENTS
RADIOTHERAPY