Surgery May Increase Survival in Stage IV Breast Cancer

Study results presented today at a European Cancer Organization conference in Berlin  may give physicians a reason to rethink the standard of care for Stage IV or metastatic breast cancer.

Treatment for women who are diagnosed from the beginning with a Stage IV breast cancer, or one that has spread to other parts of the body, is  typically focused on systemic, or whole-body treatments, such as chemotherapy.  Surgery to remove the primary tumor is usually not a priority in the treatment of metastatic disease.

However, researchers in The Netherlands found significant differences in survival between those who had had surgery to remove the primary tumor versus those who had not. In a retrospective study of 728 patients, the researchers discovered that those patients who had received surgery survived an average of 31 months, compared to 14 months for those who did not receive surgery. The five-year survival rates were also significantly different – 24.5% for the surgery group, compared to 13.1% for the non-surgery group.  Having had surgery was an independent prognostic factor even after adjusting for age, period of diagnosis, the number of metastatic sites and different types of treatment.

The researchers suggest that removal of the primary tumor reduces the number of circulating tumor cells in the rest of the body, or perhaps reactivates the immune system.  They are doing further analysis to determine if those who received surgery presented with less severe symptoms and perhaps had less severe disease.  They also plan to expand the study to look at the records of 10,000 patients over the last ten years.  In addition, the researchers would like to work with the Dutch Breast Cancer Research Group to set up a national randomised controlled trial to prospectively study the effect of surgery in Stage IV breast cancer patients.

Lots more work needs to be done to address the needs of women with Stage IV metastatic disease.  But this is one, small, encouraging step forward.

Research results presented today in Berlin, by Dr. Jetske Ruiterkamp, a surgeon from the Jeroen Bosch Hospital, Den Bosch, The Netherlands, at a European cancer congress, ECCO-15 and ESMO-34.

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