252P - Long lasting survival (LLS) after removal of primary tumor (PT) in metastatic breast cancer (MBC). Impact of age on outcome

Date 10 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Breast Cancer, Metastatic
Presenter Jose Alejandro Perez Fidalgo
Citation Annals of Oncology (2016) 27 (6): 68-99. 10.1093/annonc/mdw365
Authors J.A. Perez Fidalgo1, A. Caballero2, J.M. Cejalvo1, O. Burgues3, C. Hernando1, P. Tolosa1, A. Iranzo1, B. Bermejo1, J.B.B. Ramirez Sabio4, A. Magro5, A. Lluch-Hernandez1
  • 1Oncology And Hematology, Hospital Clinico Universitario de Valencia, 46010 - Valencia/ES
  • 2Department Of Surgery, Senology, Hospital Clinico Universitario de Valencia, Valencia/ES
  • 3Pathology Department, Hospital Clinico Universitario de Valencia, 46010 - Valencia/ES
  • 4Servicio De Oncologia Medica, Hospital de Sagunt, 46520 - Sagunt/ES
  • 5Medical Oncology, Hospital Francesc de Borja, 46702 - Gandia/ES

Abstract

Background

Retrospective evidence suggest an impact of the local control on survival in patients with MBC. A potential cause is the presence of LLS after PT removal. The aim was to assess the proportion of LLS after PT removal versus no surgery and the impact of age.

Methods

A retrospective study was performed between February 1982 and September 2005 in our institution. In order to minimize selection bias patients > 80y, with median follow-up 2 were excluded. An univariate and multivariate analysis of surgery and other prognostic variables was performed. Overall survival (OS) was calculated with Kaplan-Meier (KM). Probability of LLS was considered for patients with survival >120 months. Analyses were performed for the whole series, 65 years old cohorts.

Results

192 pts with MBC at diagnosis were recruited, of whom 112 underwent excision of the PT (Surgery group) and 80 pts did not received local therapy (Non-surgery group). Median age was 56 (48-65) for Surgery and 59 (51-70) for Non-surgery group. Operated patients were more likely to have only 1 site of metastasis. In the univariate analysis removal of PT, ER, PR, PS and number of metastatic sites were significantly related with OS. However only removal of PT and ER remained as independent prognostic factors in the multivariate analysis. With a median follow-up of 67.7 months, OS was significantly superior in Surgery group (40.7 vs 22 months, p 

Conclusions

Surgical excision of PT in younger patients with ER+ and small number of metastatic sites seems to have an impact in achieving an important proportion of LLS . No benefit in >65 years was seen.

Clinical trial identification

Legal entity responsible for the study

Instituto de Investigacion Clinico Valencia (INCLIVA) Hospital Clinico Universitario Valencia

Funding

Instituto de Investigacion Clinico Valencia (INCLIVA) Hospital Clinico Universitario Valencia

Disclosure

All authors have declared no conflicts of interest.