Preview

Tumors of female reproductive system

Advanced search

Evaluation of the scientific results of the study entitled “Opportunities for surgical treatment of patients with stage IV breast cancer” performed by Russian Society of Oncomammologists (RSOM)

https://doi.org/10.17650/1994-4098-2016-12-4-17-24

Abstract

In 11.5 % of breast cancer patients distant metastases are detected at diagnosis. The results of treatment of 608 patients of 5 Russian oncological centers are presented. Removal of the primary tumor in case of newly diagnosed advanced breast cancer increases the mean duration of life from 23 up to 35 months (p < 0.01). Three-year overall survival increases from 47 to 65 % and 5-year survival – from 21 to 45 % (p = 0.001). The most impressive effect of surgical treatment is observed in patients with bone metastases, 1–2 metastatic lesions in one anatomical region, with positive effect after systemic treatment, high expression estrogen/progesterone receptors, possibility of attaining free surgical margins.

About the Authors

A. A. Bozhok
Russian Society of Oncomammologists (RSOM); Saint Petersburg Clinical Research and Practical Center of Specialized Medical Care in Oncology
Russian Federation
68А Leningradskaya St., Pesochnyy-2 Settlement, Saint Petersburg 197758


E. E. Topuzov
Russian Society of Oncomammologists (RSOM); I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Russian Federation
41 Kirochnaya St., Saint Petersburg 191015


A. D. Zikiryakhodzhaev
Russian Society of Oncomammologists (RSOM); P.A. Herzen Moscow Oncology Research Institute – Branch of National Medical Radiological Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinskiy Proezd, Moscow 125284


A. S. Sukhot’ko
Russian Society of Oncomammologists (RSOM); P.A. Herzen Moscow Oncology Research Institute – Branch of National Medical Radiological Research Center, Ministry of Health of Russia
Russian Federation
3 2nd Botkinskiy Proezd, Moscow 125284


V. A. Khaylenko
Russian Society of Oncomammologists (RSOM); N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia
Russian Federation
23 Kashirskoe Shosse, Moscow 115478


Yu. S. Shatova
Russian Society of Oncomammologists (RSOM); Rostov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
63 14th Liniya St., Rostov-on-Don 344037


N. A. Klimov
Russian Society of Oncomammologists (RSOM); I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Russian Federation
41 Kirochnaya St., Saint Petersburg 191015


Р. М. Палтуев
Russian Society of Oncomammologists (RSOM); N.N. Petrov Research Institute of Oncology, Ministry of Health of Russia
Russian Federation
68, Leningradskaya St., Pesochnyi Settlement, Saint Petersburg 197758


References

1. Злокачественные новообразования в России в 2015 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена, 2017. 250 с. [Malignant tumors in Russia in 2015 (incidence and mortality). Ed. by A.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Moscow: P.A. Herzen Moscow Oncology Research Institute, 2017. 250 p. (In Russ.)].

2. Мерабишвили В.М. Выживаемость онкологических больных. СПб., 2011. С. 178, 261–4. [Merabishvili V.M. Survival of cancer patients. Saint Petersburg, 2011. Pp. 178, 261–4. (In Russ.)].

3. Семиглазов В.Ф., Нургазиев К.Ш., Арзуманов А.С. Опухоли молочной железы (лечение и профилактика). Алматы, 2001. [Semiglazov V.F., Nurgaziev K.Sh., Arzumanov A.S. Breast tumors (prevention and treatment). Almaty, 2001. (In Russ.)].

4. Fields R.C., Jeffe D.B., 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(12):3345–51. DOI: 10.1245/s10434-007-9527-0. PMID: 17687611.

5. Семиглазов В.Ф., Моисеенко В.М. Современное лекарственное лечение местно-распространенного и метастатического рака молочной железы. СПб., 1997. С. 26–35. [Semiglazov V.F., Moiseenko V.M. Modern drug therapy for locally advanced and metastatic breast cancer. Saint Petersburg, 1997. Pp. 26–35. (In Russ.)].

6. Khan S.A. Does resection of an intact breast primary improve survival in metastatic breast cancer? Oncology (Williston Park) 2007;21(8):924–31. PMID: 17715695.

7. Sinha P., Clements V.K., Miller S., OstrandRosenberg S. Tumor immunity: a balancing act between T cell activation, macrophage activation and tumor-induced immune suppression. Cancer Immunol Immunother 2005;54(11):1137–42. DOI: 10.1007/s00262-005-0703-4. PMID: 15877228.

8. Wood W.C. Breast surgery in advanced breast cancer: local control in the presence of metastases. Breast 2007;16(Suppl 2):S63–6. DOI: 10.1016/j.breast.2007.07.008. PMID: 17889540.

9. Baum M., Demichelli R., Hrushesky W., Retsky M. Does surgery unfavourably perturb the “natural history” of early breast cancer by accelerating the appearance of distant metastases? Eur J Cancer 2005;41(4):508–15. DOI: 10.1016/j.ejca.2004.09.031. PMID: 15737554.

10. Coffey J.C., Wang J.H., Smith M.J. Excisional surgery for cancer cure: therapy at a cost. Lancet Oncol 2003;4(12):760–8. PMID: 14662433.

11. Fisher B., Grunduz N., Saffer E.A. Influence of the interval between primary tumor removal and chemotherapy on kinetics and growth of metastases. Cancer Res 1983;43(4):1488–92. PMID: 6831397.

12. Grunduz N., Fisher B., Saffer E.A. Effect of surgical removal on the growth and kinetics of residual tumor. Cancer Res 1979;39(10):3861–5. PMID: 476622.

13. Kaufmann M., Henderson I.C., Egnofer E. Therapeutic management of metastatic breast cancer. Consensus Development in Cancer Therapy. Berlin; NY: de Gruyter, 1989. Pp. 67–8, 71, 77–8, 84.

14. Babiera G.V., 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(6):776–82. PMID: 16614878.

15. Bafford A.C., Burstein H.J., Barkley C.R. et al. Breast surgery in stage IV breast cancer: impact of staging and patient selection on overall survival. Breast Cancer Res Treat 2009;115(1):7–12. DOI: 10.1007/s10549-008-0101-7. PMID: 18581232.

16. Blanchard D.K., Shetty P.B., Hilsenbeck S.G., Elledge R.M. Association of surgery with improved survival in stage IV breast cancer patients. Ann Surg 2008;247(5):732–40. DOI: 10.1097/SLA.0b013e3181656d32. PMID: 18438108.

17. Cady B., Nathan N.R., Michaelson J.S. et al. Matched pair analyses of stage IV breast cancer with or without resection of primary breast site. Ann Surg Oncol 2008;15(12): 3384–95. DOI: 10.1245/s10434-008-0085-x. PMID: 18726129.

18. Gnerlich J., Jeffe D.B., Deshpande A.D. et al. Surgical removal of the primary tumour increases overall survival in patients with metastatic breast cancer: analysis of the 1988– 2003 SEER data. Ann Surg Oncol 2007;14(8):2187–94. DOI: 10.1245/s10434-007-9438-0. PMID: 17522944.

19. Lang J.E., Babiera G.V. Locoregional resection in stage IV breast cancer: tumor biology,

20. molecular and clinical perspectives. Surg Clin North Am 2007;87(2):527–38. DOI: 10.1016/j.suc.2007.01.001. PMID: 17498542.

21. Leung A.M., Vu H.N., Nguyen K.A. et al. Effects of surgical excision on survival of patients with stage IV breast cancer. J Surg Res 2010;161(1):83–8. DOI: 10.1016/j.jss.2008.12.030. PMID: 19375721.

22. Morrow M., Goldstein L. Surgery of the primary tumor in metastatic breast cancer: closing the barn door after the horse has bolted? J Clin Oncol 2006;24(18):2694–6. DOI: 10.1200/JCO.2006.05.9824. PMID: 16702578.

23. Nash C.H. 3rd, Jones S.E., Moon T.E. et al. Prediction of outcome in metastatic breast cancer treated with adriamycin combination chemotherapy. Cancer 1980;46(11):2380–8. PMID: 6449280.

24. Rapiti E., Verkooijen H.M., Vlastos G. Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis. J Clin Oncol 2006;24(18):2743–9. PMID: 16702580.

25. Ruterkamp J., Voogd A.C., Bosscha K. et al. Impact of breast surgery on survival in patients with distant metastases at initial presentation: a systematic review of the literature. Breast Cancer Res Treat 2010;120(1):9–16. DOI: 10.1007/s10549-009-0670-0. PMID: 20012891.

26. Hortobagyi G.N., Smith T.L., Legha S.S. et al. Multivariate analysis of prognostic factors in metastatic breast cancer. J Clin Oncol 1983;1(12):776–86. PMID: 6668494.

27. Vincent M.D., Powles T.J., Skeet R. et al. An analysis of possible prognostic features of long term and short term survivors of metastatic breast cancer. Eur J Cancer Clin Oncol 1986;22(9):1059–65. PMID: 3780813.

28. Caras I., Grigorescu A., Stavaru C. et al. Evidence for immune defects in breast and lung cancer patients. Cancer Immunol Immunother 2004;53(12):1146–52. DOI: 10.1007/s00262-004-0556-2. PMID: 15185014.

29. Campbell M.J., Scott J., Maecker H.T. et al. Immune dysfunction and micrometastases in women with breast cancer. Breast Cancer Res Treat 2005;91(2):163–71. DOI: 10.1007/s10549-004-7048-0. PMID: 15868444.

30. Badwe R., Hawaldar R., Nair N. et al. Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomized controlled trial. Lancet Oncol 2015;16(13):1380–8. DOI: 10.1016/S1470-2045(15)00135-7. PMID: 26363985.

31. Soran A., Ozmen V., Ozbas S. et al. A randomized controlled trial evaluating resection of the primary breast tumor in women presenting with de novo stage IV breast cancer: Turkish Study (Protocol MF07-01). J Clin Oncol 2016;34 Supl: abstr 1005.

32. Chia S.K., Speers C.H., D’yachkova Y. et al. The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer. Cancer 2007;110(5):973–9. DOI: 10.1002/cncr.22867. PMID: 17647245.

33. Comen E.A., Norton L., Massague J. Breast cancer tumour size, nodal status and prognosis: biology trumps anatomy. J Clin Oncol 2011;29(19):2610–2. DOI: 10.1200/JCO.2011.36.1873. PMID: 21606411.

34. Danna E.A., Sinha P., Gilbert M. et al. Surgical removal of primary tumor reverses tumor-induced immunosuppression despite the presence of metastatic disease. Cancer Res 2004;64(6):2205–11. PMID: 15026364.

35. Khan S.A., Stewart A.K., Morrow M. Does aggressive local therapy improve survival in metastatic breast cancer? Surgery 2002;132(4):620–6. PMID: 12407345.

36. Harris E., Barry M., Kell M.R. 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(9):2828–34. DOI: 10.1245/s10434-013-2998-2. PMID: 23653043.


Review

For citations:


Bozhok A.A., Topuzov E.E., Zikiryakhodzhaev A.D., Sukhot’ko A.S., Khaylenko V.A., Shatova Yu.S., Klimov N.A., Палтуев Р.М. Evaluation of the scientific results of the study entitled “Opportunities for surgical treatment of patients with stage IV breast cancer” performed by Russian Society of Oncomammologists (RSOM). Tumors of female reproductive system. 2016;12(4):17-24. (In Russ.) https://doi.org/10.17650/1994-4098-2016-12-4-17-24

Views: 960


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1994-4098 (Print)
ISSN 1999-8627 (Online)