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Prognostic factors for recurrent breast cancer patients with an isolated, limited number of lung metastases and implications for pulmonary metastasectomy†
Version of Record online: 1 APR 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 12, pages 2890–2901, 15 June 2010
How to Cite
Yhim, H.-Y., Han, S.-W., Oh, D.-Y., Han, W., Im, S.-A., Kim, T.-Y., Kim, Y. T., Noh, D.-Y., Chie, E. K., Ha, S. W., Park, I. A. and Bang, Y.-J. (2010), Prognostic factors for recurrent breast cancer patients with an isolated, limited number of lung metastases and implications for pulmonary metastasectomy. Cancer, 116: 2890–2901. doi: 10.1002/cncr.25054
This study was partly presented at the 45th American Society of Clinical Oncology Annual Meeting, May 29-June 2, 2009, Orlando, Florida.
- Issue online: 11 JUN 2010
- Version of Record online: 1 APR 2010
- Manuscript Accepted: 28 SEP 2009
- Manuscript Revised: 25 AUG 2009
- Manuscript Received: 17 JUN 2009
- breast cancer;
- lung metastasis;
- prognostic factors;
- pulmonary metastasectomy
The aim of this study was to evaluate the clinical treatment outcomes of recurrent breast cancer with a limited number of isolated lung metastases, and to evaluate the role of pulmonary metastasectomy.
The authors consecutively enrolled 140 recurrent breast cancer patients with isolated lung metastasis from 1997 to 2007 in Seoul National University Hospital and retrospectively analyzed 45 patients who had <4 metastatic lesions.
Fifteen patients had pulmonary metastasectomy followed by systemic treatment (pulmonary metastasectomy group), and 30 received systemic treatment alone (nonpulmonary metastasectomy group). The 3-year progression-free survival (PFS) and 4-year overall survival (OS) was significantly longer in the pulmonary metastasectomy group than in the nonpulmonary metastasectomy group (3-year PFS, 55.0% vs 4.5%, P < .001; 4-year OS, 82.1% vs 31.6%, P = .001). In multivariate analysis, a disease-free interval (DFI) of <24 months (hazard ratio [HR], 4.53; 95% CI, 1.72-11.90), no pulmonary metastasectomy (HR, 9.52; 95% CI, 3.34-27.18) and biologic subtypes such as human epithelial growth factor receptor-2 positive (HR, 3.00; 95% CI, 1.04-8.64) and triple negative (HR, 3.92; 95% CI, 1.32-11.59) were independent prognostic factors for shorter PFS.
The authors' results demonstrated that DFI and biologic subtypes of tumor are firm, independent, prognostic factors for survival, and pulmonary metastasectomy can be a reasonable treatment option in this population. Further prospective studies are warranted to evaluate the role of pulmonary metastasectomy. Cancer 2010. © 2010 American Cancer Society.