title: Impact of Surgery on Survival in Stage IV Breast Cancer.
abstract: We aimed to assess retrospectively the survival outcome in patients with stage IV breast cancer who underwent surgery. In a retrospective, nonrandomized study of stage IV breast cancer patients diagnosed in a single institution between 2000 and 2012, we assessed patient's survival in the context of baseline characteristics. A total 678 patients with metastatic breast cancer were included; 412 (60.77%) underwent surgery for the primary tumor (Surgery group), and 266 (39%) did not underwent surgery for the primary tumor (Nonsurgery group), with a median follow-up of 41 months. Patients in the Surgery group had longer survival (41 versus 27 months, p < 0.0029). The 5-year survival rate for Surgery group was 34% compared with 14% for the Nonsurgery group. A multivariate analysis revealed surgery (p = 0.0003), large tumor size (p = 0.0195), ER-positive (p < 0.0001), and metastasis at presentation (p = 0.0032) were prognostic variables. Loco-regional surgery does confer a survival advantage in stage IV breast cancer, however, selection bias cannot be excluded, a well-designed and powerful randomized, controlled trial would be valuable to answer whether surgery can improve survival.
authors: Department of General Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Badria
authors: B
authors: AlJohani
authors: Department of General Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Osama
authors: O
authors: AlMalik
authors: Department of General Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Ehab
authors: E
authors: Anwar
authors: Department of Pathology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Asma
authors: A
authors: Tulbah
authors: Department of Radiation Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Mohamed
authors: M
authors: Alshabanah
authors: Department of Medical Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Adher
authors: A
authors: AlSyaed
authors: Department of Medical Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Dahish
authors: D
authors: Ajarim
authors: Department of Medical Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Taher
authors: T
authors: ALTweigeri
mesh_terms: D000328:Adult; D001365:Axilla / Q000473:pathology / Q000601:surgery; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008408:Mastectomy; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: metastatic breast cancer; stage IV breast cancer surgery; survival; systemic therapy