TY - JOUR
T1 - Significance of primary lesion resection in Stage IV breast cancer
AU - Shien, Tadahiko
AU - Iwata, Hiroji
N1 - Funding Information:
This report was supported in part by the National Cancer Center Research and Development Fund (26-A-4) from the Ministry of Health, Labour and Welfare and the Practical Research for Innovative Cancer Control (15ck0106046h0002) from Japan Agency for Medical Research and Development, AMED.
Publisher Copyright:
© The Author 2017. Published by Oxford University Press. All rights reserved.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Primary breast tumor resection is not recommended with metastatic disease due to lack of evidence indicating prognostic benefit. Results from ongoing trials are needed to test tumor resection efficacy.Abstract: Systemic treatment with drugs is administered to prolong survival and palliate symptoms in Stage IV breast cancer patients who have distant metastases at diagnosis. Surgical procedures for the primary tumor are not actively recommended in guidelines due to lack of evidence indicating prognostic benefit. Recently, several retrospective studies have shown primary tumor resection to prolong overall survival in patients with Stage IV breast cancer. Prospective randomized trials began enrolling patients to examine this possibility and two have already reported results. However, the results of these two trials were discordant. The first trial, conducted in India, reported negative effects of primary tumor resection after primary systemic therapy. A Turkish trial then obtained a positive effect of surgery as primary treatment. Several questions regarding the effects, timing, methods and eligibility for primary surgery have yet to be answered. Robust evidence, which is anticipated from other ongoing trials examining surgery for metastatic breast cancer, is eagerly awaited.
AB - Primary breast tumor resection is not recommended with metastatic disease due to lack of evidence indicating prognostic benefit. Results from ongoing trials are needed to test tumor resection efficacy.Abstract: Systemic treatment with drugs is administered to prolong survival and palliate symptoms in Stage IV breast cancer patients who have distant metastases at diagnosis. Surgical procedures for the primary tumor are not actively recommended in guidelines due to lack of evidence indicating prognostic benefit. Recently, several retrospective studies have shown primary tumor resection to prolong overall survival in patients with Stage IV breast cancer. Prospective randomized trials began enrolling patients to examine this possibility and two have already reported results. However, the results of these two trials were discordant. The first trial, conducted in India, reported negative effects of primary tumor resection after primary systemic therapy. A Turkish trial then obtained a positive effect of surgery as primary treatment. Several questions regarding the effects, timing, methods and eligibility for primary surgery have yet to be answered. Robust evidence, which is anticipated from other ongoing trials examining surgery for metastatic breast cancer, is eagerly awaited.
KW - Prognosis
KW - Stage IV breast cancer
KW - Surgery
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U2 - 10.1093/jjco/hyx027
DO - 10.1093/jjco/hyx027
M3 - Review article
C2 - 28334844
AN - SCOPUS:85027104785
VL - 47
SP - 381
EP - 384
JO - Japanese Journal of Clinical Oncology
JF - Japanese Journal of Clinical Oncology
SN - 0368-2811
IS - 5
M1 - hyx027
ER -