Impact of locoregional treatment on the survival of breast cancer patients with synchronous metastases

We retrospectively studied the impact of locoregional treatment (LRT), consisting mainly of locoregional radiotherapy (LRR) directed to the breast and regional lymphatics, on the survival of breast cancer patients with synchronous metastases. Among 581 eligible patients treated in our institution between 1980 and 2004, 320 received LRT (group A) and 261 received no LRT (group B). With a median follow-up of 39 months, the 3-year OS rates were 43.4% and 26.7% in group A and group B (p=0.00002). The association between LRT and improved survival was particularly marked in women with visceral metastases. LRT was an independent prognostic factor in multivariate analysis (hazards ratio, 0.70 [95%CI 0.58-0.85]; p=0.0002). The adjusted hazards ratio for late death (³ 1 year) was 0.76 (95%CI: 0.61-0.96, p=0.02). Our results confirm the survival advantage conferred by surgery or radiation therapy of the primary tumor in breast cancer patients with synchronous metastases. Well-designed prospective studies, including locoregional radiotherapy as the only locoregional treatment, are needed to re-evaluate treatment of the primary breast tumor in patients with metastases at diagnosis, and to identify those patients who are most likely to benefit.

Bibliographic Reference

Le Scodan R et al.: "Breast Cancer With Synchronous Metastases: Survival Impact of Exclusive Locoregional Radiotherapy"; J Clin Oncol. 2009 Feb 9. [Epub ahead of print]