内容紹介
Summary
We investigated whether primary tumor resection performed at our department for the purpose of local control affects the disease progression of Stage Ⅳ breast cancer. Fifteen patients who underwent primary tumor resection between 2009 and 2017 were investigated. The median age at the time of surgery was 63 years. There were two postoperative deaths(1 at<1 year postoperatively and 1 at<2 years postoperatively). The median postoperative stable disease(SD)period was 11 months overall and was 12 months or longer in 7 patients. SD was attained by all patients with the first drug treatment after primary tumor resection. Patients who tended to have a longer postoperative SD period did not receive preoperative drug treatment, were luminal HER2-positive, and had one metastatic organ. Regardless of surgery timing and reason, there were no cases of rapid postoperative disease progression. In all patients, postoperative local control was satisfactory, and continuation of medical treatment was feasible for distant metastatic tumors. These data signify that primary tumor resection can be considered to treat Stage Ⅳ breast cancer for the purpose of local control.
要旨
当科で局所コントロール目的に原発巣切除を施行したStage Ⅳ乳癌について,切除が病勢に影響するのか検討した。対象は2009～2017年,Stage Ⅳで原発巣切除を施行した15例とした。手術時年齢中央値は63歳。術後死亡症例は術後1年未満1例,2年未満1例に認めた。全症例の術後SD期間中央値は11か月,術後SD期間が12か月以上の症例は7例であった。原発巣切除後の最初に施行された薬物治療は全症例でSDが得られた。術後SD期間が長い傾向を認めた症例は,術前薬物療法のない症例,Luminal HER2,転移臓器数が1臓器の症例であった。手術時期,手術の理由にかかわらず術後に急激な病勢の増悪は認めず,すべての症例で術後の局所コントロールは良好で,遠隔転移巣に対する加療継続が可能であった。Stage Ⅳ乳癌において局所コントロール目的に原発巣切除を考慮することが全身治療に影響しないことが示された。
目次
We investigated whether primary tumor resection performed at our department for the purpose of local control affects the disease progression of Stage Ⅳ breast cancer. Fifteen patients who underwent primary tumor resection between 2009 and 2017 were investigated. The median age at the time of surgery was 63 years. There were two postoperative deaths(1 at<1 year postoperatively and 1 at<2 years postoperatively). The median postoperative stable disease(SD)period was 11 months overall and was 12 months or longer in 7 patients. SD was attained by all patients with the first drug treatment after primary tumor resection. Patients who tended to have a longer postoperative SD period did not receive preoperative drug treatment, were luminal HER2-positive, and had one metastatic organ. Regardless of surgery timing and reason, there were no cases of rapid postoperative disease progression. In all patients, postoperative local control was satisfactory, and continuation of medical treatment was feasible for distant metastatic tumors. These data signify that primary tumor resection can be considered to treat Stage Ⅳ breast cancer for the purpose of local control.
要旨
当科で局所コントロール目的に原発巣切除を施行したStage Ⅳ乳癌について,切除が病勢に影響するのか検討した。対象は2009～2017年,Stage Ⅳで原発巣切除を施行した15例とした。手術時年齢中央値は63歳。術後死亡症例は術後1年未満1例,2年未満1例に認めた。全症例の術後SD期間中央値は11か月,術後SD期間が12か月以上の症例は7例であった。原発巣切除後の最初に施行された薬物治療は全症例でSDが得られた。術後SD期間が長い傾向を認めた症例は,術前薬物療法のない症例,Luminal HER2,転移臓器数が1臓器の症例であった。手術時期,手術の理由にかかわらず術後に急激な病勢の増悪は認めず,すべての症例で術後の局所コントロールは良好で,遠隔転移巣に対する加療継続が可能であった。Stage Ⅳ乳癌において局所コントロール目的に原発巣切除を考慮することが全身治療に影響しないことが示された。