Stage IV Breast Cancer: Is Surgical Resection of Clinical Utility?
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Should a surgical resection be performed for patients presented with stage IV breast cancer? The systemic nature of this stage does not support surgery. Instead, primary systemic treatment and radiation has been the standard approach.1 Recently, Gnerlich et al.2 analyzing the 1988–2003 Surveillance, Epidemiology, and End Results (SEER) program data of 9734 stage IV patients, concluded that resection of the primary tumor reduces mortality in patients with stage IV disease. Thus, surgical resection could be considered for these patients, although high-quality evidence for decision-making is lacking.
In a recent issue of the Annals of Surgical Oncology, Cady et al.3 report on a retrospective study of stage IV breast cancer patients treated with or without surgery. The authors concluded that case selection bias in primary breast cancer resection in state IV patients might explain most, if not all, the apparent survival advantage of such surgery. In this study the rate of stage IV disease wa ...
- Goldhirsch A, Wood WC, Gelber RD, Coates AS, Thürlimann B, Senn HJ, et al. Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer. Ann Surg Oncol. 2007;18(7):1133–44.
- Gnerlich J, Jeffe DB, Deshpande AD, Beers C, Zander C, Margenthaler JA. Surgical removal of the primary tumor increases overall survival in patients with metastatic breast cancer: analysis of the 1988–2003 SEER data. Ann Surg Oncol. 2007;14(8):2187–94. CrossRef
- Cady B, Nathan NR, Michaelson JS, Golshan M, Smith BL. Matched pair analyses of stage IV breast cancer with or without resection of primary breast site. Ann Surg Oncol. 2008;15(12):3384–95. CrossRef
- Petrelli NJ. SEER data: it can be thought provoking, but where do we go from here? Ann Surg Oncol. 2007;14(8):2173–4. CrossRef
- Fatouros M, Baltoyiannis G, Roukos DH. The predominant role of surgery in the prevention and new trends in the surgical treatment of women with BRCA1/2 mutations. Ann Surg Oncol. 2008;15(1):21–33. CrossRef
- Roukos DH. Prognosis of breast cancer in carriers of BRCA1 and BRCA2 mutations. N Engl J Med. 2007;357(15):1555–6; (author reply 1556). CrossRef
- Roukos DH, Briasoulis E. Individualized preventive and therapeutic management of hereditary breast ovarian cancer. Nat Clin Pract Oncol. 2007;4(10):578–90. CrossRef
- Roukos DH, Agnanti NJ, Paraskevaidis E, Kappas AM. Approaching the dilemma between prophylactic bilateral mastectomy or oophorectomy for breast and ovarian cancer prevention in carriers of BRCA1 or BRCA2 mutations. Ann Surg Oncol. 2002;9(10):941–3.
- Roukos DH, Kappas AM, Tsianos E. Role of surgery in the prophylaxis of hereditary cancer syndromes. Ann Surg Oncol. 2002;9(7):607–9. CrossRef
- Agnantis NJ, Paraskevaidis E, Roukos D. Preventing breast, ovarian cancer in BRCA carriers: rational of prophylactic surgery and promises of surveillance. Ann Surg Oncol. 2004;11(12):1030–4. CrossRef
- Fatouros M, Roukos DH, Arampatzis I, Sotiriadis A, Paraskevaidis E, Kappas AM. Factors increasing local recurrence in breast-conserving surgery. Expert Rev Anticancer Ther. 2005;5(4):737–45. CrossRef
- Roukos DH. Early-stage gastric cancer: a highly treatable disease. Ann Surg Oncol. 2004;11:127–9. CrossRef
- Ziogas D, Baltogiannis G, Fatouros M, Roukos DH. Identifying and preventing high-risk gastric cancer individuals with CDH1 mutations. Ann Surg. 2008;247(4):714–5. CrossRef
- Kappas AM, Roukos DH. Quality of surgery determinant for the outcome of patient with gastric cancer. Ann Surg Oncol. 2002;9(9):828–30. CrossRef
- Roukos DH. Linking contralateral breast cancer with genetics. Radiother Oncol. 2008;86:139–41. CrossRef
- Roukos DH, Kappas AM, Agnantis NJ. Perspectives and risks of breast-conservation therapy for breast cancer. Ann Surg Oncol. 2003;10:718–21. CrossRef
- Liakakos T, Roukos DH. More controversy than ever—challenges and promises towards personalized treatment of gastric cancer. Ann Surg Oncol. 2008;15(4):956–60. CrossRef
- Briasoulis E, Fatouros M, Roukos DH. Level I evidence in support of perioperative chemotherapy for operable gastric cancer: sufficient for wide clinical use? Ann Surg Oncol. 2007;14:2691–5. CrossRef
- Roukos DH. Adjuvant chemoradiotherapy in gastric cancer: wave goodbye to extensive surgery? Ann Surg Oncol. 2002;9:220–1.
- Briasoulis E, Liakakos T, Dova L, Fatouros M, Tsekeris P, Roukos DH, et al. Selecting a specific pre- or postoperative adjuvant therapy for individual patients with operable gastric cancer. Expert Rev Anticancer Ther. 2006;6:931–9. CrossRef
- Roukos DH, Lorenz M, Encke A. Evidence of survival benefit of extended (D2) lymphadenectomy in western patients with gastric cancer based on a new concept: a prospective long-term follow-up study. Surgery. 1998;123(5):573–8. CrossRef
- Roukos DH, Murray S, Briasoulis E. Molecular genetic tools shape a roadmap towards a more accurate prognostic prediction and personalized management of cancer. Cancer Biol Ther. 2007;6(3):308–12. CrossRef
- Roukos DH. Genetics and genome-wide association studies: surgery-guided algorithm and promise for future breast cancer personalized surgery. Expert Rev Mol Diagn. 2008;8(5):587–597. CrossRef
- Roukos DH, Lykoudis E, Liakakos T. Genomics and challenges toward personalized breast cancer local control. J Clin Oncol. 2008;26(26):4360–1. CrossRef
- Roukos DH. HER2 and response to paclitaxel in node-positive breast cancer. N Engl J Med. 2008;358:197 (author reply 198). CrossRef
- Roukos DH. Breast-cancer stromal cells with TP53 mutations. N Engl J Med. 2008;358(15):1636 (author reply 1636).
- Roukos DH. Innovative genomic-based model for personalized treatment of gastric cancer: integrating current standards and new technologies. Expert Rev Mol Diagn. 2008;8(1):29–39. CrossRef
- Roukos DH. Assessing both genetic variation (SNPs/CNVs) and gene-environment interactions may lead to personalized gastric cancer prevention. Expert Rev Mol Diagn. 2009;9(1):1–6. CrossRef
- Stage IV Breast Cancer: Is Surgical Resection of Clinical Utility?
Annals of Surgical Oncology
Volume 16, Issue 5 , pp 1437-1438
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors