Primary tumor resection in stage IV breast cancer: A systematic review and meta-analysis

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Weikai XiaoXiaoming Xie

Abstract

The impact of primary tumor resection (PTR) on survival is still controversial in stage IV breast cancer. This systematic review and meta-analysis aimed to evaluate the impact of PTR on overall survival (OS) in stage IV breast cancer. Comprehensive literature search was conducted to identify studies comparing PTR with no PTR for stage IV breast cancer. The quality of the studies was assessed using Cochrane risk of bias tool and Newcastle-Ottawa Scale. We used subgroup and meta-regression analysis to assess the contribution of demographic and clinical factors to heterogeneity. Data on 714 patients in 3 randomized controlled trials (RCTs) and 67,272 patients in 30 observational studies were included. One RCT was terminated early due to poor recruitment, and the remaining two RCTs' design were different, thus RCTs were only performed systematic review without meta-analysis. The pooled outcomes of 30 observational studies showed PTR significantly improved OS (HR = 0.65; 95%CI, 0.61 to 0.70, P < 0.001, I2 = 80%). Additionally, PTR was associated with better distant progression-free survival (HR = 0.42; 95%CI, 0.29 to 0.60) but did not impact progression-free survival. Subgroup analysis showed PTR benefit in patients who had only one...Continue Reading

Citations

Oct 1, 2020·Clinical Medicine Insights. Oncology·Joanna S LeeAtilla Soran
Nov 13, 2020·Asia-Pacific Journal of Clinical Oncology·Yeon Joo KimEun Kyung Choi
Nov 16, 2020·The Journal of Surgical Research·Janelle-Cheri A MillenFrancis I Macedo
Jul 7, 2021·The Breast : Official Journal of the European Society of Mastology·Yu-Qiu ChenJun Gu
Jul 31, 2021·American Journal of Surgery·Caitlin E MarksJennifer K Plichta

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