Tratamiento quirúrgico del tumor primario en pacientes con cáncer de mama en estadio IV / Surgical treatment of the primary tumor in stage iv breast cancer

INTRODUCCIÓN: El objetivo del estudio fue analizar el impacto de la cirugía locorregional en la supervivencia de pacientes con cáncer de mama estadio IV. PACIENTES Y MÉTODOS: Estudio retrospectivo que incluyó a pacientes con cáncer de mama y metástasis sincrónicas. Se excluyó a pacientes con ECOG superior a 2 y elevado riesgo anestésico-quirúrgico. Se evaluaron las siguientes variables: edad, tamaño tumoral, afectación ganglionar, tipo histológico, grado histológico, receptores hormonales, sobreexpresión de HER2, número de órganos afectos, localización de las metástasis y tratamiento quirúrgico. El impacto de la cirugía y las distintas variables clínico-patológicas sobre la supervivencia se analizó mediante un modelo de regresión de Cox. RESULTADOS: Se incluyó a 69 pacientes, de los que 36 (52,2%) fueron intervenidos quirúrgicamente (grupo estudio). Tras un seguimiento medio de 34 meses, la supervivencia media de la serie fue de 55 meses y no se encontraron diferencias significativas entre el grupo estudio y el grupo de pacientes sin intervención quirúrgica (p = 0,187). Se identificaron 2 factores relacionados con una peor supervivencia: el número de órganos con metástasis (HR = 1,69; IC 95%: 1,05- 2,71) y el cáncer triple negativo (HR = 3,49; IC 95%: 1,39-8,74). La cirugía locorregional, sin embargo, no se relacionó con la supervivencia. CONCLUSIONES: El tratamiento quirúrgico locorregional no se asoció con mayor supervivencia en pacientes con cáncer de mama en estadio IV. El número de órganos con metástasis y los tumores triple negativo fueron factores de mal pronóstico de supervivencia

INTRODUCTION: The aim of the study was to analyze the impact of loco-regional surgery on survival of patients with stage IV breast cancer. PATIENTS AND METHODS: Retrospective study that included patients with breast cancer and synchronous metastases. Patients with ECOG above 2 and high-risk patients were excluded. The following variables were evaluated: age, tumor size, nodal involvement, histological type, histological grade, hormone receptor status, HER2 overexpression, number of affected organs, location of metastases and surgical treatment. The impact of surgery and several clinical and pathologic variables on survival was analyzed by Cox regression model. RESULTS: A total of 69 patients, of whom 36 (52.2%) underwent surgery (study group) were included. After a mean follow-up of 34 months, the median survival of the series was 55 months and no significant differences between the study group and the group of patients without surgery (P=0.187) were found. Two factors associated with worse survival were identified: the number of organs with metastases (HR = 1.69, IC 95%: 1.05-2.71) and triple negative breast cancer (HR = 3.49, IC 95%: 1.39-8.74). Loco-regional surgery, however, was not associated with survival. CONCLUSIONS: Loco-regional surgical treatment was not associated with improved survival inpacientes with stage IV breast cancer. The number of organs with metastases and tumors were triple negative prognostic factors for survival

[Surgical treatment of the primary tumor in stage IV breast cancer]. / Tratamiento quirúrgico del tumor primario en pacientes con cáncer de mama en estadio IV.

INTRODUCTION: The aim of the study was to analyze the impact of loco-regional surgery on survival of patients with stage IV breast cancer. PATIENTS AND METHODS: Retrospective study that included patients with breast cancer and synchronous metastases. Patients with ECOG above 2 and high-risk patients were excluded. The following variables were evaluated: age, tumor size, nodal involvement, histological type, histological grade, hormone receptor status, HER2 overexpression, number of affected organs, location of metastases and surgical treatment. The impact of surgery and several clinical and pathologic variables on survival was analyzed by Cox regression model. RESULTS: A total of 69 patients, of whom 36 (52.2%) underwent surgery (study group) were included. After a mean follow-up of 34 months, the median survival of the series was 55 months and no significant differences between the study group and the group of patients without surgery (P=0.187) were found. Two factors associated with worse survival were identified: the number of organs with metastases (HR=1.69, IC 95%: 1.05-2.71) and triple negative breast cancer (HR=3.49, IC 95%: 1.39-8.74). Loco-regional surgery, however, was not associated with survival. CONCLUSIONS: Loco-regional surgical treatment was not associated with improved survival inpacientes with stage IV breast cancer. The number of organs with metastases and tumors were triple negative prognostic factors for survival.