Academic Journal
Locally Ablative Therapies in Oligometastatic Breast Cancer.
| Τίτλος: | Locally Ablative Therapies in Oligometastatic Breast Cancer. |
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| Συγγραφείς: | Nierenberg TC; Department of Surgery, Duke University Medical Center, Durham, North Carolina., Thomas SM; Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina.; Biostatistics Shared Resource, Duke Cancer Institute, Durham, North Carolina., Halliday I; Department of Surgery, Duke University Medical Center, Durham, North Carolina., van den Bruele AB; Department of Surgery, Duke University Medical Center, Durham, North Carolina.; Duke Cancer Institute, Durham, North Carolina., Wang T; Department of Surgery, Duke University Medical Center, Durham, North Carolina.; Duke Cancer Institute, Durham, North Carolina., Rosenberger LH; Department of Surgery, Duke University Medical Center, Durham, North Carolina.; Duke Cancer Institute, Durham, North Carolina., Flanagan MR; Department of Surgery, University of Washington, Seattle., DiLalla GA; Department of Surgery, Duke University Medical Center, Durham, North Carolina.; Duke Cancer Institute, Durham, North Carolina., Hwang ES; Department of Surgery, Duke University Medical Center, Durham, North Carolina.; Duke Cancer Institute, Durham, North Carolina., Plichta JK; Department of Surgery, Duke University Medical Center, Durham, North Carolina.; Duke Cancer Institute, Durham, North Carolina.; Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina. |
| Πηγή: | JAMA surgery [JAMA Surg] 2026 May 01; Vol. 161 (5), pp. 468-477. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101589553 Publication Model: Print Cited Medium: Internet ISSN: 2168-6262 (Electronic) Linking ISSN: 21686254 NLM ISO Abbreviation: JAMA Surg Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Chicago, IL : American Medical Association, [2013]- |
| Ιατρικοί όροι (MeSH): | Breast Neoplasms*/pathology , Breast Neoplasms*/mortality , Breast Neoplasms*/surgery , Breast Neoplasms*/therapy , Bone Neoplasms*/secondary , Bone Neoplasms*/surgery , Ablation Techniques*, Lung Neoplasms/secondary ; Lung Neoplasms/surgery ; Brain Neoplasms/secondary ; Brain Neoplasms/surgery ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Humans ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Survival Rate ; Neoplasm Metastasis |
| Περίληψη: | Importance: Management of de novo metastatic breast cancer (dnMBC) often focuses on palliation. As such, the potential survival benefit of surgery or ablative therapy remains unclear, particularly for those with oligometastatic disease. Objective: To evaluate the association of surgical and/or locally ablative treatment of the primary and/or metastatic sites with overall survival (OS) in patients with single-site oligometastatic dnMBC. Design, Setting, and Participants: This was a retrospective cohort study using the National Cancer Database. Patients diagnosed with oligometastatic, single-site (ie, brain, bone, liver, or lung) dnMBC receiving systemic therapy were selected from the National Cancer Database (2010-2020). Study groups included no locally ablative therapy/surgery (NLT), primary breast tumor resection only (BR), metastatic site ablative therapy only (MT), and both therapies (BR+MT). Logistic regression identified factors associated with treatment strategy. Multivariable modeling was used to estimate the association of treatment with OS. Data were analyzed from August 2024 to September 2025. Exposures: NLT, BR, MT, or BR+MT therapies for oligometastatic, single-site dnMBC. Main Outcomes and Measures: The primary outcome measure was OS. Results: Among 22 433 patients (median [IQR] age, 61 [50-70] years; 22 126 female biological sex at birth [98.6%]; median [IQR] follow-up, 61.5 [60.7-62.5] months), bone-only metastases were most common in 15 441 (68.8%). Locally ablative therapies were uncommon (BR+MT, 1438 [6.4%]; MT, 2381 [10.6%]; BR, 3435 [15.3%] vs NLT, 15 179 [67.7%]). Older age (>70 years, odds ratio [OR], 2.49; 95% CI, 2.24-2.76 vs <50 years [reference]) and higher comorbidity score (>2, OR, 1.36; 95% CI, 1.16-1.60 vs 0 [reference]) were associated with NLT. Compared with NLT, BR (hazard ratio [HR], 0.62; 95% CI, 0.58-0.67) and BR+MT (HR, 0.60; 95% CI, 0.54-0.67) were associated with improved survival, but OS was worse for MT (HR, 1.22; 95% CI, 1.14-1.31). Conclusions and Relevance: Results of this cohort study suggest that few patients with single-site dnMBC undergo surgical/ablative therapy, although BR+MT and BR only were associated with improved OS. However, if invasive interventions are considered for patients with single-site dnMBC, resection of the breast primary may be beneficial. |
| Σχόλια: | Comment in: JAMA Surg. 2026 May 1;161(5):477-478. doi: 10.1001/jamasurg.2026.0106.. (PMID: 41779408) |
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| Grant Information: | K12 AR084231 United States AR NIAMS NIH HHS; P30 CA014236 United States CA NCI NIH HHS |
| Entry Date(s): | Date Created: 20260304 Date Completed: 20260710 Latest Revision: 20260829 |
| Update Code: | 20260829 |
| PubMed Central ID: | PMC12961602 |
| DOI: | 10.1001/jamasurg.2026.0098 |
| PMID: | 41779401 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2168-6262 |
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| DOI: | 10.1001/jamasurg.2026.0098 |