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Table 1 Retrospective studies evaluating the treatment of the primary tumor in breast cancer patients with synchronous metastases

From: Exclusive and adjuvant radiotherapy in breast cancer patients with synchronous metastases

Authors (ref) Database Years of inclusion Local treatment Number of patients total/local treatment/no local treatment Characteristics associated with a higher OS rate in multivariate analysis Multivariate Analysis of Overall Survival Hazards Ratio for Death (95%CI) with local treatment
Kahn et al. [13] National cancer database of the American college of surgeons 1990-1993 S 16023/9162/6861 S, systemic therapy, number of metastatic sites HR OS (RO) = 0.61 (0.58-0.65)
HR (R1) = 0.751 (0.71-0.793)
Gnerlich et al. [11] SEER 1988-2003 S 9734/4578/5156   HR OS = 0.57 (0.55-0.60)
Bafford et al. [7] Dana Farber Cancer Institute, Brigham and Women's Hospital and Massachusetts General Hospital 1998-2005 S 147/61/86 S, ER+, Her2+, no CNS metastasis HR OS = 0.47 (p = 0.003)
Shien et al. [18] National Cancer Center Hospital 1962-2007 S 326/160/184 S, age <50, soft tissue or bone metastasis HR OS =
0.89 (0.79-1)
Blanchard et al. [8] Laboratory of the university of texas health science center 1973-1991 S 395/242/153 S, ER +, PR+, number of metastatic sites HR OS = 0.609 (0.489-0.757)
Fields et al. [10] Washington university medical center 1996-2005 S 409/287/222 S, Bone only metastasis HR OS = 0.53 (0.42-0.67)
No difference in time to metastatic progression between the 2 groups
Babiera et al. [6] MD Anderson cancer center 1997-2002 S 224/82/142 Only one site of metastasis, HER2+, Caucasian ethnicity HR OS = 0.5 (0.21-1.19)
HR TTFP = 0.54 (0.38-0.77, p = 0.0007)
Hazard et al. [12] Lynn Sage Breast Center (Northwestern memorial Hospital) 1995-2005 S 111/47/64 NA HR OS = 0.798 (p = 0.52)
HR TTFP = 0.49 (p = 0.015)
Cady et al. [9] Massachusetts General Hospital and Birgham and Women's Hospital 1970-2002 S 622/234/388 Young age, RH +, bone only metastasis Matched-pair analysis: benefit of surgery p < 0.0001
Ruiterkamp et al. [17] Eindhoven Cancer Registry 1993-2004 S 728/288/440 Surgery, age, no more than one metastatic site, no concomitant disease(p = 0.06), systemic therapy HR OS = 0.62 (95%CI = 0.51-0.76)
Leung et al. [19] Medical College of Virginia Campus of Virginia Commonwealth University, 1990-2000 S 157/52/105 Chemotherapy No benefit in multivariate analysis
Rapiti et al. [16] Geneva cancer registry 1977-1996 S 300/127/173 Age < 60, none N3, ER+, none visceral metastasis, none CNS metastasis, hormonal treatment, surgery with negative margins HR OS = 0.6 if R0 (0.4-1.0)
NS if R1
Le Scodan et al. [14] René Huguenin Cancer Center 1984-2004 RT 581/320/261 Only one metastatic site, young age, LRT, no visceral metastases, N0 HR OS = 0.7 (0.58-0.85)
  1. S: surgery of the primary tumor, RT: radiation therapy, LRT: locoregional treatment, HR: hazard ratio, OS: overall survival, TTFP: time to first progression, 95%CI: 95% confidence interval, MST: median survival time, CNS: central nervous system, ER+: tumor positive estrogen receptor, PR+: tumor positive progesteron receptor, Her2+: Her2 positive status, R0: surgery with negative margins, R1: surgery with positive margins, N0: clinical N0 lymph node status