Breast surgery for metastatic breast cancer

Imagem de Miniatura
Arquivos
art_TOSELLO_Breast_surgery_for_metastatic_breast_cancer_2018.PDF (536.32 KB)
Citações na Scopus
4
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
TOSELLO, Giuliano
TORLONI, Maria Regina
NEEMAN, Teresa
RIERA, Rachel
Citação
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, n.3, article ID CD011276, 45p, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background Metastatic breast cancer is not a curable disease, but women with metastatic disease are living longer. Surgery to remove the primary tumour is associated with an increased survival in other types of metastatic cancer. Breast surgery is not standard treatment for metastatic disease, however several recent retrospective studies have suggested that breast surgery could increase the women's survival. These studies have methodological limitations including selection bias. A systematic review mapping all randomised controlled trials addressing the benefits and potential harms of breast surgery is ideal to answer this question. Objectives To assess the effects of breast surgery in women with metastatic breast cancer. Search methods We conducted searches using the MeSH terms 'breast neoplasms', 'mastectomy', and 'analysis, survival' in the following databases: the Cochrane Breast Cancer Specialised Register, CENTRAL, MEDLINE (by PubMed) and Embase (by OvidSP) on 22 February 2016. We also searched ClinicalTrials.gov (22 February 2016) and the WHO International Clinical Trials Registry Platform (24 February 2016). We conducted an additional search in the American Society of Clinical Oncology (AS CO) conference proceedings in July 2016 that included reference checking, citation searching, and contacting study authors to identify additional studies. Selection criteria The inclusion criteria were randomised controlled trials of women with metastatic breast cancer at initial diagnosis comparing breast surgery plus systemic therapy versus systemic therapy alone. The primary outcomes were overall survival and quality of life. Secondary outcomes were progression-free survival (local and distant control), breast cancer-specific survival, and toxicity from local therapy. Data collection and analysis Two review authors independently conducted trial selection, data extraction, and 'Risk of bias' assessment (using Cochrane's 'Risk of bias' tool), which a third review author checked. We used the GRADE tool to assess the quality of the body of evidence. We used the risk ratio (RR) to measure the effect of treatment for dichotomous outcomes and the hazard ratio (HR) for time-to-event outcomes. We calculated 95% confidence intervals (CI) for these measures. We used the random-effects model, as we expected clinical or methodological heterogeneity, or both, among the included studies. Main results We included two trials enrolling 624 women in the review. It is uncertain whether breast surgery improves overall survival as the quality of the evidence has been assessed as very low (HR 0.83, 95% CI 0.53 to 1.31; 2 studies; 624 women). The two studies did not report quality of life. Breast surgery may improve local progression-free survival (HR 0.22, 95% CI 0.08 to 0.57; 2 studies; 607 women; low quality evidence), while it probably worsened distant progression-free survival (HR 1.42, 95% CI 1.08 to 1.86; 1 study; 350 women; moderate-quality evidence). The two included studies did not measure breast cancer-specific survival. Toxicity from local therapy was reported by 30-day mortality and did not appear to differ between the two groups (RR 0.99, 95% CI 0.14 to 6.90; 1 study; 274 women; low-quality evidence). Authors' conclusions Based on existing evidence from two randomised clinical trials, it is not possible to make definitive conclusions on the benefits and risks of breast surgery associated with systemic treatment for women diagnosed with metastatic breast cancer. Until the ongoing clinical trials are finalised, the decision to perform breast surgery in these women should be individualised and shared between the physician and the patient considering the potential risks, benefits, and costs of each intervention.
Palavras-chave
URI
https://observatorio.fm.usp.br/handle/OPI/27096
Referências
  1. Perez-Fidalgo JA, 2011, BREAST, V20, P548, DOI 10.1016/j.breast.2011.06.005
  2. Anwar S, 2012, COLORECTAL DIS, V14, P920, DOI 10.1111/j.1463-1318.2011.02817.x
  3. Badwe R, 2013, CANC RES S, V73
  4. Badwe R, 2015, LANCET ONCOL, V16, P1380, DOI 10.1016/S1470-2045(15)00135-7
  5. Bermas HR, 2009, BREAST COMPREHENSIVE, V2, P1211
  6. Blanchard DK, 2008, ANN SURG, V247, P732, DOI 10.1097/SLA.0b013e3181656d32
  7. Bourgier C, 2010, RADIOTHER ONCOL, V96, P199, DOI 10.1016/j.radonc.2010.02.028
  8. Caudle AS, 2012, ADV THERAPY BREAST D, V1, P1001
  9. Danna EA, 2004, CANCER RES, V64, P2205, DOI 10.1158/0008-5472.CAN-03-2646
  10. Darby S, 2001, LANCET, V378, P1707, DOI 10.1016/S0140-6736(11)61629-2
  11. Dawood S, 2009, J CLIN ONCOL, V27, P220, DOI 10.1200/JCO.2008.17.9952
  12. Di Lascio S, 2014, BREAST CARE, V9, P7, DOI 10.1159/000358750
  13. Ellis LM, 2014, J CLIN ONCOL, V32, P1277, DOI 10.1200/JCO.2013.53.8009
  14. Ernst MF, 2007, BREAST, V16, P344, DOI 10.1016/j.breast.2007.01.001
  15. Fayers PM, 1999, EORTC QLQ C30 SCORIN
  16. Ferlay J, 2010, GLOBOCAN 2012 V2 0 C
  17. Ferrell BR, 1997, CANCER NURS, V20, P398, DOI 10.1097/00002820-199712000-00003
  18. Fields RC, 2007, ANN SURG ONCOL, V14, P3345, DOI 10.1245/s10434-007-9527-0
  19. FISHER B, 1989, CANCER RES, V49, P1996
  20. Flanigan RC, 2001, NEW ENGL J MED, V345, P1655, DOI 10.1056/NEJMoa003013
  21. Giordano SH, 2004, CANCER, V100, P44, DOI 10.1002/cncr.11859
  22. Gnerlich J, 2008, BREAST J, V14, P538, DOI 10.1111/j.1524-4741.2008.00644.x
  23. Harris E, 2013, ANN SURG ONCOL, V20, P2828, DOI 10.1245/s10434-013-2998-2
  24. Higgins J, 2011, COCHRANE HDB SYSTEMA
  25. Hurvitz SA, 2013, BREAST CANCER RES TR, V142, P603, DOI 10.1007/s10549-013-2734-4
  26. Karnoub AE, 2007, NATURE, V449, P557, DOI 10.1038/nature06188
  27. Khan SA, 2002, SURGERY, V132, P620, DOI 10.1067/msy.2002.127544
  28. Kiess AP, 2012, CANCER-AM CANCER SOC, V118, P1982, DOI 10.1002/cncr.26484
  29. Lang JE, 2013, ANN SURG ONCOL, V20, P1893, DOI 10.1245/s10434-012-2844-y
  30. Le Scodan R, 2009, J CLIN ONCOL, V27, P1375, DOI 10.1200/JCO.2008.19.5396
  31. Ly BH, 2010, BREAST CANCER RES TR, V119, P537, DOI 10.1007/s10549-009-0610-z
  32. McMaster University, 2015, GRADEPRO GDT GRADEPR
  33. McNeely ML, 2012, CANCER-AM CANCER SOC, V118, P2226, DOI 10.1002/cncr.27468
  34. Mickisch GHJ, 2001, LANCET, V358, P966, DOI 10.1016/S0140-6736(01)06103-7
  35. Moher D, 2009, ANN INTERN MED, V151, P264, DOI 10.7326/0003-4819-151-4-200908180-00135
  36. Morrogh M, 2008, CANCER-AM CANCER SOC, V112, P1445, DOI 10.1002/cncr.23319
  37. Neuman HB, 2010, CANCER-AM CANCER SOC, V116, P1226, DOI 10.1002/cncr.24873
  38. Parmar MKB, 1998, STAT MED, V17, P2815, DOI 10.1002/(SICI)1097-0258(19981230)17:24<2815::AID-SIM110>3.0.CO;2-8
  39. Petrelli F, 2012, MED ONCOL, V29, P3282, DOI 10.1007/s12032-012-0310-0
  40. Pusic AL, 2009, PLAST RECONSTR SURG, V124, P345, DOI 10.1097/PRS.0b013e3181aee807
  41. Rapiti E, 2006, J CLIN ONCOL, V24, P2743, DOI 10.1200/JCO.2005.04.2226
  42. Rastogi S, 2014, INDIAN J MED PAEDIAT, V35, P203, DOI 10.4103/0971-5851.142035
  43. Rhu J, 2015, ANZ J SURG, V85, P240, DOI 10.1111/ans.12548
  44. Ruiterkamp J, 2009, EJSO-EUR J SURG ONC, V35, P1146, DOI 10.1016/j.ejso.2009.03.012
  45. Ruiterkamp J, 2012, BMC SURG, V12, DOI 10.1186/1471-2482-12-5
  46. Ruiterkamp J, 2010, BREAST CANCER RES TR, V120, P9, DOI 10.1007/s10549-009-0670-0
  47. Sales CACC, 2001, REV BRAS CANCEROL, V47, P263
  48. Samiee S, 2012, CURRENT ONCOLOGY, V9, P270
  49. Slamon DJ, 2001, NEW ENGL J MED, V344, P783, DOI 10.1056/NEJM200103153441101
  50. Sobin L, 2002, TNM CLASSIFICATION M
  51. Soran A, 2016, J CLIN ONCOLOGY S, V34
  52. Soran A, 2009, BREAST J, V15, P399, DOI 10.1111/j.1524-4741.2009.00744.x
  53. Swain SM, 2015, NEW ENGL J MED, V372, P724, DOI 10.1056/NEJMoa1413513
  54. The Nordic Cochrane Centre The Cochrane Collaboration, 2012, REV MAN REVMAN VERS
  55. Thomas A, 2016, JAMA SURG, V151, P424, DOI 10.1001/jamasurg.2015.4539

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - ODS/03