原发性手术在新发转移性乳腺癌中的作用。

Berkay Demirors, Berk Goktepe, Hannah Medeck, Serdar Ozbas, Atilla Soran
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引用次数: 0

摘要

大约6-10%的乳腺癌在诊断时是转移性的,称为新生转移性乳腺癌(dnMBC)。全身治疗仍然是dnMBC的一线治疗,但越来越多的证据表明,原发肿瘤的辅助局部区域治疗(LRT)可以增加无进展和总生存期(OS)。尽管可能存在选择偏倚,但来自近50万患者的真实数据显示,患者接受原发肿瘤切除是因为生存获益。在这一患者群体中,LRT倡导者的主要问题不是初级手术对dnMBC患者是否有益,而是谁是一个好的候选者。寡转移性疾病(OMD)是dnMBC的一个独特的亚群,影响有限数量的器官。在乳腺癌患者中,特别是那些患有OMD、仅骨或有利亚型的患者中,LRT可以获得更好的OS。虽然目前乳腺护理专家对如何治疗dnMBC患者没有共识,但在广泛的多学科讨论之后,应该考虑对一部分患者进行dnMBC的初级手术。
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The Role of Primary Surgery in De Novo Metastatic Breast Carcinoma.

Approximately 6-10% of all breast carcinoma is metastatic at diagnosis, termed de novo metastatic breast carcinoma (dnMBC). Systemic therapy remains the first line of treatment in dnMBC, but there is growing evidence that adjuvant locoregional treatment (LRT) of the primary tumor increases progression-free and overall survival (OS). Although selection bias may exist, real-world data from nearly half a million patients show that patients are undergoing primary tumor removal because of the survival benefit. The main question for the advocates for LRT in this patient population is not whether primary surgery is beneficial in dnMBC patients, but rather who is a good candidate for it. Oligometastatic disease (OMD) is a distinct subset of dnMBC that affects a limited number of organs. A better OS can be achieved with LRT in breast cancer patients, especially in those with OMD, bone only, or favorable subtypes. Though there is currently no consensus among breast care specialists on how to treat dnMBC patients, primary surgery for dnMBC should be taken into consideration for a subset of patients following an extensive multidisciplinary discussion.

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