Central Surgical AssociationDoes aggressive local therapy improve survival in metastatic breast cancer?*
Section snippets
Methods
The NCDB is a joint project of the Commission on Cancer of the ACS and the American Cancer Society, whose goal is to lower the morbidity and mortality of cancer by providing information about cancer management and outcomes. The NCDB collects data annually on all forms of cancer throughout the country from computerized hospital cancer registries.2, 3 Eleven NCDB calls for data have been issued since 1989 and have yielded in excess of 11 million incident cancer cases from more than 1900 hospital
Results
Women who presented with stage IV breast cancer comprised 4.1% of the total number of breast cancer cases accrued to the NCDB during a 4-year period from 1990 to 1993 (a cohort for which the most recent mature follow up data are available). Their mean age was 62.5 years, and 50% of the study population was between 60 and 79 years of age. Of 16,023 women who met the selection criteria 6861 (42.8%) received no surgical resection of the primary tumor. Some of these patients were reported as
Discussion
In this study, on the basis of a retrospective review of data from the NCDB, we find that the use of PM or TM in women presenting with metastatic breast cancer affords an independent, statistically significant survival advantage, with a reduction in the hazard of death from 1.0 in the no operation group, to 0.88 in women undergoing PM, and to 0.74 in those undergoing TM. Univariate analysis shows this benefit increases steadily between women who have no surgical procedure (3-year survival,
References (17)
- et al.
Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomized trial
Lancet
(1999) - et al.
Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer
N Engl J Med
(2001) - et al.
Regional diversity and breadth of the National Cancer Data Base
Cancer
(1998) - et al.
Clinical highlights from the National Cancer Data Base, 2000
CA Cancer J Clin
(2000) International classification of diseases for oncology
(1992)Manual for staging of cancer
(1992)Analyzing survival data from clinical trials and observational studies
(1995)Regression models and life tables
Journal of the Royal Statistical Society: Series B
(1972)
Cited by (349)
Breast surgery for patients with de novo metastatic breast cancer: A meta-analysis of randomized controlled trials
2024, European Journal of Surgical OncologyOperative Management in Stage IV Breast Cancer
2023, Surgical Clinics of North AmericaPrimary tumor consolidative therapy improves the outcomes of patients with advanced EGFR-mutant lung adenocarcinoma treated with first-line osimertinib
2024, Therapeutic Advances in Medical Oncology
- *
Reprint requests: Seema A. Khan, MD, Department of Surgery, Northwestern University Medical School, 201 E Huron St, Suite 10-105, Chicago, IL 60611.