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KMID : 1134120100130010090
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Journal of Breast Cancer
2010 Volume.13 No. 1 p.90 ~ p.95
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The Impact of Primary Tumor Resection on the Survival of Patients with Stage IV Breast Cancer
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Ahn Soo-Kyung
Han Won-Shik
Moon Hyeong-Gon
Yu Jong-Han
Ko Eun-Young
Bae Jin-Hye
Min Jun-Won
Kim Tae-You
Im Seock-Ah
Han Sae-Won
Ha Sung-Whan
Chie Eui-Kyu
Oh Seung-Keun
Youn Yeo-Kyu
Kim Sung-Won
Hwang Ki-Tae
Roh Dong-Young
Oh Do-Youn
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Abstract
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Purpose: The main treatment for stage IV breast cancer is currently systemic therapy. Surgical resection of the primary tumor is usually done for treating the tumor-related complications. Recent studies have suggested that surgery may improve the long-term survival of stage IV breast cancer patients. We evaluated the impact of the primary surgical resection site on the survival of stage IV breast cancer patients.
Methods: We reviewed the records of the stage IV breast cancer patients who were treated at Seoul University Hospital between April 1992 and December 2007. The tumor and clinical characteristics, the type of treatments and the overall survival were compared between the surgically versus nonsurgically treated patients.
Results: Of the 198 identified patients, 110 (55.8%) received surgical excision of their primary tumor and 88 (44.2%) did not. The mean survival was 67 months vs. 42 months for the surgically treated patients vs. the patients without surgery, respectively (p=0.0287). On a multivariate analysis with using the Cox model and after adjusting for the estrogen receptor status, visceral metastases, the number of metastatic sites and trastuzumab treatment, surgery was an independent factor for improved survival (hazard ratio, 0.55; 95% confidence interval, 0.31-0.97; p=0.041).
Conclusion: Surgical resection of the primary tumor in stage IV breast cancer patients was independently associated with improved survival. Randomized prospective trials are needed to firmly recommend surgical resection of the primary tumor in stage IV breast cancer patients.
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KEYWORD
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Breast neoplasms, Neoplasm metastasis, Stage IV, Surgery, Survival
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