Survival Impact of Locoregional Treatment of the Primary Tumor in De Novo Metastatic Breast Cancers in a Large Multicentric Cohort Study: A Propensity Score-Matched Analysis
Elvire Pons-Tostivint
(1)
,
Youlia Kirova
(2)
,
Amélie Lusque
(1)
,
Mario Campone
(3)
,
Julien Geffrelot
(4)
,
Chafika Mazouni
(5)
,
Audrey Mailliez
(6)
,
David Pasquier
(6)
,
Nicolas Madranges
(7)
,
Nelly Firmin
(8)
,
Agathe Crouzet
(9)
,
Anthony Gonçalves
(10)
,
Clémentine Jankowski
(11)
,
Thibault de La Motte Rouge
(12)
,
Nicolas Pouget
(13)
,
Brigitte de La Lande
(13)
,
Delphine Mouttet-Boizat
(14)
,
Jean-Marc Ferrero
(15)
,
Lionel Uwer
(16)
,
Jean-Christophe Eymard
(17)
,
Marie-Ange Mouret-Reynier
(18)
,
Thierry Petit
(19)
,
Mathieu Robain
(20)
,
Thomas Filleron
(1)
,
Christian Cailliot
(21)
,
Florence Dalenc
(1)
1
Institut Claudius Regaud
2 Département de radiothérapie oncologique [Paris]
3 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
4 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
5 Département de chirurgie générale [Gustave Roussy]
6 Service de radiothérapie / curiethérapie
7 Institut Bergonié [Bordeaux]
8 Département d'oncologie Médicale
9 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
10 CRCM - Centre de Recherche en Cancérologie de Marseille
11 Service de chirurgie [Centre Georges-François Leclerc]
12 CRLCC - CRLCC Eugène Marquis
13 CRLCC René Huguenin - CRLCC René Huguenin
14 Departement de chirurgie [Institut Curie]
15 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
16 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
17 Institut Jean Godinot [Reims]
18 UNICANCER/CJP - Centre Jean Perrin [Clermont-Ferrand]
19 CRLCC Paul Strauss - Centre Paul Strauss
20 Institut Curie [Paris]
21 UNICANCER
2 Département de radiothérapie oncologique [Paris]
3 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
4 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
5 Département de chirurgie générale [Gustave Roussy]
6 Service de radiothérapie / curiethérapie
7 Institut Bergonié [Bordeaux]
8 Département d'oncologie Médicale
9 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
10 CRCM - Centre de Recherche en Cancérologie de Marseille
11 Service de chirurgie [Centre Georges-François Leclerc]
12 CRLCC - CRLCC Eugène Marquis
13 CRLCC René Huguenin - CRLCC René Huguenin
14 Departement de chirurgie [Institut Curie]
15 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
16 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
17 Institut Jean Godinot [Reims]
18 UNICANCER/CJP - Centre Jean Perrin [Clermont-Ferrand]
19 CRLCC Paul Strauss - Centre Paul Strauss
20 Institut Curie [Paris]
21 UNICANCER
Elvire Pons-Tostivint
- Fonction : Auteur
- PersonId : 735567
- IdHAL : elvire-pons-tostivint
- ORCID : 0000-0003-4478-0523
- IdRef : 165642122
Youlia Kirova
- Fonction : Auteur
- PersonId : 1274102
- ORCID : 0000-0002-1795-7509
- IdRef : 167248006
Amélie Lusque
- Fonction : Auteur
- PersonId : 1313391
- ORCID : 0000-0001-9691-5536
Mario Campone
- Fonction : Auteur
- PersonId : 761947
- ORCID : 0000-0002-5196-5908
- IdRef : 075165716
Audrey Mailliez
- Fonction : Auteur
- PersonId : 1192608
- ORCID : 0000-0002-0475-8631
David Pasquier
- Fonction : Auteur
- PersonId : 172712
- IdHAL : david-pasquier
- ORCID : 0000-0001-6019-7309
- IdRef : 073342831
Nelly Firmin
- Fonction : Auteur
- PersonId : 785742
- ORCID : 0000-0001-5839-6261
- IdRef : 17657039X
Anthony Gonçalves
- Fonction : Auteur
- PersonId : 791165
- ORCID : 0000-0001-7570-7439
- IdRef : 059729481
Clémentine Jankowski
- Fonction : Auteur
- PersonId : 1063158
Jean-Marc Ferrero
- Fonction : Auteur
- PersonId : 1192594
- ORCID : 0000-0003-0069-3743
- IdRef : 034779752
Lionel Uwer
- Fonction : Auteur
- PersonId : 909997
Marie-Ange Mouret-Reynier
- Fonction : Auteur
- PersonId : 919130
- ORCID : 0000-0001-5542-5813
- IdRef : 142415146
Thierry Petit
- Fonction : Auteur
- PersonId : 895122
- ORCID : 0000-0002-8746-0725
- IdRef : 075194155
Thomas Filleron
- Fonction : Auteur
- PersonId : 768535
- IdHAL : thomas-filleron
- ORCID : 0000-0003-0724-0659
- IdRef : 119887223
Résumé
Introduction
Improvement in overall survival (OS) by locoregional treatment (LRT) of the primary tumor in de novo metastatic breast cancer (MBC) patients remains controversial.
Objective
The aim of our study was to evaluate the impact of LRT on OS in a large retrospective cohort of de novo MBC patients, with regard to immunohistochemical characteristics and pattern of metastatic dissemination.
Methods
We conducted a multicentric retrospective study of patients diagnosed with de novo MBC selected from the French Epidemiological Strategy and Medical Economics MBC database (NCT03275311) between 2008 and 2014. Overall, 4276 women were included in the study. LRT comprised either radiotherapy, surgery, or both.
Results
LRT was used in 40% of patients. Compared with no LRT, patients who received LRT were younger (p < 0.0001) and were more likely to have only one metastatic site (p < 0.0001) or bone-only metastases (p < 0.0001). LRT was associated with a significantly better OS based on landmark multivariate analysis at 1-year (hazard ratio 0.65, 95% confidence interval 0.55–0.76, p < 0.001). Similar results were observed in all sensitivity analyses, including propensity score matching. In subgroup analysis, LRT was associated with better OS in patients with hormone receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative (61.6 vs. 45.9 months, p < 0.001) and HER2-positive tumors (77.2 vs. 52.6 months, p = 0.008), but not in triple-negative tumors (19 vs. 18.6 months, p = 0.54), and was also associated with a reduction in the risk of death in visceral metastatic patients (p < 0.001).
Conclusions
LRT was associated with a significantly better OS in de novo MBC patients, including patients with visceral involvement at diagnosis; however, LRT did not impact OS in triple-negative MBC.