Cancer Res Treat.  2022 Apr;54(2):478-487. 10.4143/crt.2021.632.

Effect of Postoperative Radiotherapy after Primary Tumor Resection in De Novo Stage IV Breast Cancer: A Multicenter Retrospective Study (KROG 19-02)

• Kim YJ
• Kim YJ
• Kim YB
• Lee IJ
• Kwon J
• Kim K
• Cha J
• Kim M
• Jo IY
• Kim JH
• Park J
• Kim JH
• Kim J
• Shin KH
• Kim SS

• KMID: 2528217
• DOI: http://doi.org/10.4143/crt.2021.632

Abstract

Purpose
This study aimed to investigate the impact of postoperative radiotherapy (PORT) in de novo metastatic breast cancer (dnMBC) patients undergoing planned primary tumor resection (PTR) and to identify the subgroup of patients who would most benefit from PORT.
Materials and Methods
This study enrolled 426 patients with dnMBC administered PTR alone or with PORT. The primary and secondary outcomes were overall and progression-free survival (OS and PFS), respectively.
Results
The median follow-up time was 53.7 months (range, 3.1 to 194.4). The 5-year OS and PFS rates were 73.2% and 32.0%, respectively. For OS, clinical T3/4 category, triple-negative breast cancer (TNBC), postoperative chemotherapy alone were significantly poor prognostic factors, and administration of PORT failed to show its significance. Regarding PFS, PORT was a favorable prognostic factor (hazard ratio, 0.64; 95% confidence interval, 0.50 to 0.82; p < 0.001), in addition to T1/2 category, ≤ 5 metastases, and non-TNBC. According to the multivariate analyses of OS in the PORT group, we divided the patients into three groups (group 1, T1/2 and non-TNBC [n=193]; group 2, T3/4 and non-TNBC [n=171]; and group 3, TNBC [n=49]), and evaluated the effect of PORT. Although PORT had no significance for OS in all subgroups, it was a significant factor for good prognosis regarding PFS in groups 1 and 2, not in group 3.
Conclusion
PORT was associated with a significantly better PFS in patients with dnMBC who underwent PTR. Patients with clinical T1/2 category and non-TNBC benefited most from PORT, while those with TNBC showed little benefit.

Keyword

Stage IV breast cancer; Breast surgery; Postoperative radiotherapy; Survival

Figure

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  Fig. 1 Overall survival and progression-free survival according to the administration of postoperative radiotherapy (PORT) in group 1 (A, B), group 2 (C, D) and group 3 (E, F).

Reference

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