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25.10.2023 | Epidemiology

Surgery of the primary tumor in patients with de novo metastatic breast cancer: a nationwide population-based retrospective cohort study in Belgium

verfasst von: Mariana Brandão, Diogo Martins-Branco, Claudia De Angelis, Peter Vuylsteke, Richard D. Gelber, Nancy Van Damme, Lien van Walle, Arlindo R. Ferreira, Matteo Lambertini, Francesca Poggio, Didier Verhoeven, Annelore Barbeaux, Francois P. Duhoux, Hans Wildiers, Carmela Caballero, Ahmad Awada, Martine Piccart-Gebhart, Kevin Punie, Evandro de Azambuja

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2024

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Abstract

Purpose

We aimed to assess the impact of surgery of primary tumor in overall survival (OS) of women with de novo metastatic breast cancer.

Methods

Nationwide, population-based retrospective cohort study of women diagnosed with de novo metastatic breast cancer in Belgium, between Jan/2010-Dec/2014. Data was obtained from the Belgian Cancer Registry and administrative databases. “Surgery” group was defined by surgery of primary tumor up to nine months after diagnosis. We excluded women who did not receive systemic treatment or did not complete nine months follow-up after diagnosis. All the subsequent analyses reporting on overall survival and the stratified outcome analyses were performed based on this nine-month landmark cohort. OS was estimated using Kaplan-Meier method and compared using adjusted Cox proportional hazards models controlling for confounders with 95% confidence intervals (CI). We performed a stratified analysis according to surgery timing and a propensity score matching analysis.

Results

1985 patients, 534 (26.9%) in the “Surgery” and 1451 (73.1%) in the “No Surgery” group. Patients undergoing surgery were younger (p < 0.001), had better performance status (PS) (p < 0.001), and higher proportion of HER2-positive and triple-negative breast cancer (p = 0.012). Median follow-up was 86.0 months (82.6–88.5). Median OS was 60.1 months (57.1–68.2) in the “Surgery” vs. 41.9 months (39.8–44.2) in the “No Surgery” group (adjusted HR 0.56; 0.49–0.64). OS was similar when surgery was performed upfront or after systemic treatment. Propensity score matching analysis confirmed the same findings.

Conclusion

Among patients receiving systemic treatment for de novo metastatic breast cancer and surviving nine months or more, those who received surgery of the primary tumor within nine months of diagnosis have longer subsequent survival than those who did not.

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Titel: Surgery of the primary tumor in patients with de novo metastatic breast cancer: a nationwide population-based retrospective cohort study in Belgium
verfasst von: Mariana Brandão
Diogo Martins-Branco
Claudia De Angelis
Peter Vuylsteke
Richard D. Gelber
Nancy Van Damme
Lien van Walle
Arlindo R. Ferreira
Matteo Lambertini
Francesca Poggio
Didier Verhoeven
Annelore Barbeaux
Francois P. Duhoux
Hans Wildiers
Carmela Caballero
Ahmad Awada
Martine Piccart-Gebhart
Kevin Punie
Evandro de Azambuja
Publikationsdatum: 25.10.2023
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 2/2024
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-023-07116-6

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Surgery of the primary tumor in patients with de novo metastatic breast cancer: a nationwide population-based retrospective cohort study in Belgium