TY - JOUR
T1 - Effect of Postoperative Radiotherapy after Primary Tumor Resection in de Novo Stage IV Breast Cancer
T2 - A Multicenter Retrospective Study (KROG 19-02)
AU - Kim, Yeon Joo
AU - Kim, Yeon Joo
AU - Kim, Yong Bae
AU - Lee, Ik Jae
AU - Kwon, Jeanny
AU - Kim, Kyubo
AU - Cha, Jihye
AU - Kim, Myungsoo
AU - Jo, In Young
AU - Kim, Jung Hoon
AU - Park, Jaehyeon
AU - Kim, Jin Hee
AU - Kim, Juree
AU - Shin, Kyung Hwan
AU - Kim, Su Ssan
N1 - Publisher Copyright:
© 2022 by the Korean Cancer Association.
PY - 2022/4
Y1 - 2022/4
N2 - Purpose This study aimed to investigate the impact of postoperative radiotherapy (PORT) in de novo metastatic breast cancer (dnMBC) patients undergoing planned primary tumor resection (PTR) and to identify the subgroup of patients who would most benefit from PORT. Materials and Methods This study enrolled 426 patients with dnMBC administered PTR alone or with PORT. The primary and secondary outcomes were overall and progression-free survival (OS and PFS), respectively. Results The median follow-up time was 53.7 months (range, 3.1 to 194.4). The 5-year OS and PFS rates were 73.2% and 32.0%, respectively. For OS, clinical T3/4 category, triple-negative breast cancer (TNBC), postoperative chemotherapy alone were significantly poor prognostic factors, and administration of PORT failed to show its significance. Regarding PFS, PORT was a favorable prognostic factor (hazard ratio, 0.64; 95% confidence interval, 0.50 to 0.82; p < 0.001), in addition to T1/2 category, ≤ 5 metastases, and non-TNBC. According to the multivariate analyses of OS in the PORT group, we divided the patients into three groups (group 1, T1/2 and non-TNBC [n=193]; group 2, T3/4 and non-TNBC [n=171]; and group 3, TNBC [n=49]), and evaluated the effect of PORT. Although PORT had no significance for OS in all subgroups, it was a significant factor for good prognosis regarding PFS in groups 1 and 2, not in group 3. Conclusion PORT was associated with a significantly better PFS in patients with dnMBC who underwent PTR. Patients with clinical T1/2 category and non-TNBC benefited most from PORT, while those with TNBC showed little benefit.
AB - Purpose This study aimed to investigate the impact of postoperative radiotherapy (PORT) in de novo metastatic breast cancer (dnMBC) patients undergoing planned primary tumor resection (PTR) and to identify the subgroup of patients who would most benefit from PORT. Materials and Methods This study enrolled 426 patients with dnMBC administered PTR alone or with PORT. The primary and secondary outcomes were overall and progression-free survival (OS and PFS), respectively. Results The median follow-up time was 53.7 months (range, 3.1 to 194.4). The 5-year OS and PFS rates were 73.2% and 32.0%, respectively. For OS, clinical T3/4 category, triple-negative breast cancer (TNBC), postoperative chemotherapy alone were significantly poor prognostic factors, and administration of PORT failed to show its significance. Regarding PFS, PORT was a favorable prognostic factor (hazard ratio, 0.64; 95% confidence interval, 0.50 to 0.82; p < 0.001), in addition to T1/2 category, ≤ 5 metastases, and non-TNBC. According to the multivariate analyses of OS in the PORT group, we divided the patients into three groups (group 1, T1/2 and non-TNBC [n=193]; group 2, T3/4 and non-TNBC [n=171]; and group 3, TNBC [n=49]), and evaluated the effect of PORT. Although PORT had no significance for OS in all subgroups, it was a significant factor for good prognosis regarding PFS in groups 1 and 2, not in group 3. Conclusion PORT was associated with a significantly better PFS in patients with dnMBC who underwent PTR. Patients with clinical T1/2 category and non-TNBC benefited most from PORT, while those with TNBC showed little benefit.
KW - Breast surgery
KW - Postoperative radiotherapy
KW - Stage IV breast cancer
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85128493527&partnerID=8YFLogxK
U2 - 10.4143/crt.2021.632
DO - 10.4143/crt.2021.632
M3 - Article
C2 - 34265890
AN - SCOPUS:85128493527
SN - 1598-2998
VL - 54
SP - 478
EP - 487
JO - Cancer Research and Treatment
JF - Cancer Research and Treatment
IS - 2
ER -