Locoregional therapy containing surgery in metastatic breast cancer: Systematic review and meta-analysis.

Jamal Rahmani, Ala Elhelali, Morteza Yousefi, Yanin Chavarri-Guerra, Matin Ghanavati, Mahdi Shadnoush, Mohammad Esmaeil Akbari, Seyed Hossein Ardehali, Atieh Akbari, Regina Barragan-Carrillo, Mohammad Hadizadeh

Journal: The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 2024;22(1):43-51

PMID: 37858431

Full Text on Elsevier Science View on PubMed

Abstract

INTRODUCTION

The role of locoregional therapy (LRT) containing surgery and systematic therapy in metastatic breast cancer patients remains controversial. This study investigated the effect of LRT in patients who were initially diagnosed with metastatic breast cancer (MBC) on overall survival (OS), locoregional progression-free survival (PFS), and distant systemic PFS.

METHODS

The related keywords were searched in MEDLINE/PubMed, SCOPUS, and Web of Science databases up to August 15th, 2022. Hazard ratios (HR) with 95% confidence intervals (CIs) were pooled by the random-effects model.

RESULTS

Seven articles with 1626 participants compared LRT with only systemic therapy (ST) for patients with de novo MBC. LRT did not improve (p = 0.28) OS compared to ST (HR: 0.83, 95% CI: 0.60, 1.16). LRT significantly improved locoregional PFS outcomes compared to ST (HR: 0.31, 95% CI: 0.15, 0.60, p = 0.001). LRT significantly (p = 0.001) improved OS in patients with solitary bone metastases (HR: 0.48; 95% CI: 0.35-0.67).

CONCLUSION

LRT improves locoregional PFS. Furthermore, LRT improves OS in patients with solitary bone metastases.

Address: Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: [email protected].; Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, USA.; Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.; National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Science and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Department of Anesthesiology and Critical Care, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: 10.1016/j.surge.2023.09.003

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MeSH Terms: Humans, Female, Breast Neoplasms, Combined Modality Therapy, Progression-Free Survival