Source: DGNews  |  Posted 2 years ago

By Ed Susman

SAN ANTONIO, Tex -- December 14, 2009 -- Researchers suggested here at the 32nd
Annual San Antonio Breast Cancer Symposium (SABCS) that some women who present with advanced, metastatic breast cancer can benefit by surgical removal of the
primary tumour.

In a retrospective analysis conducted from records at 43 hospitals in Spain,
researchers identified 159 women who underwent surgery and who had a median
overall survival of 2.94 years following diagnosis of metastatic breast cancer.
The median survival for the 446 women who did not receive surgery was 1.83
years (P < .001), said Sara López-Tarruella, MD, Hospital Clínico
San Carlos, Madrid, Spain.

“Local surgery of the primary tumour is associated with an increase in overall
survival, especially for patients with skin or soft-tissue metastasis,” she
said during her poster presentation on December 11.

“These analyses suggest that locoregional control of the primary tumour should
be considered for the treatment of advanced disease in selected patients,” she
said. However, she said there is a need to conduct randomised controlled trials
among women who present with metastatic breast cancer at first diagnosis.

Why resection of the primary tumour would impact outcome in metastatic disease,
she said remains controversial. “The biology behind this hypothesis is not
fully understood and also deserves further evaluation in the translational
setting.”

The Alamo Project is a retrospective analysis of patients diagnosed with breast
cancer between 1990 and 1997 at hospitals in the Spanish Breast Cancer Research
Group (GEICAM). More than 15,000 breast cancer patients were included in the
study, but Dr. López-Tarruella and colleagues reviewed cases only of those
women with metastatic breast cancer at first diagnosis -- a total of 605 women.

A stratified analysis of metastasis by organ found no differences in outcomes
between surgery and non-surgery if the disease spread to visceral organs, the
lungs, or to bone. However, in the 114 women who experienced skin or
soft-tissue metastases, removal of the primary tumour appeared to make a
significant difference in outcome.

Dr. López-Tarruella said that the 37 women who underwent primary tumour
resection had a median survival of 4.52 years compared with a median survival
of 1.77 years for the 77 women who did not have surgery.

Presentation title: Impact on Survival of Primary Tumor Resection in
Women With Metastatic Breast Cancer at Initial Diagnosis. The Alamo Project.
Abstract 3104