Clinical Analysis Of Primary Resection Of Stage ? Breast Cancer

Objective:To explore the effect of the resection of primary focus of stage IV breast cancer at the first visit on their prognosis.And,to analyze the relevant factors that may affect the operation of stage IV breast cancer.Then,find out the dominant population with initial stage IV breast cancer suitable for surgery.Finally,to provide ideas and theoretical basis for the development of individualized treatments for initial stage IV breast cancer in the future.Methods:Clinical data of patients with initial stage IV breast cancer diagnosed at Breast Cancer Center of the Third Affiliated Hospital of Kunming Medical University between January 2009 and January 2018 were retrospectively collected.According to elinical data of patients,Patients can be divided into surgieal group and non-surgical group.Patients with complete resection of primary tumors were included in the surgical group.And,patients without any operation on primary focus were divided into the non-surgical group.After statistical analysis and comparing the prognostic differences between two groups,we can evaluate the effect of the resection of primary focus of initial stage ? breast cancer on their prognosis.Results:1.Into the group of patients with a total of 244 cases,of which 109(44.7%)underwent surgery treatment,135 cases(55.3%)did not undergo surgery treatment,surgical group and those who did not(age<50 years old and 50 or higher),N stage,ER,PR,Her-2,eomorbid disease and molecular classification of tumor,chemotherapy,targeted therapy and endocrine therapy,etc than no statistical differences.2.The mean cumulative survival time of the surgical group was 35.2 months,and that of the non-surgery group was 22.3 months.And the mean survival time was 12.9 months longer in the surgical group.The median survival time of the non-surgical group was 27 months(95%CI:24-34),and the median survival time of the surgical group(95%CI:62-*)was not obtained due to the large number of cut-off points in the surgical group,P<0.0001,which indicated that the survival of the surgical group was significantly higher than that of the non-surgical group.3.COX univariate analysis revealed that surgery(P<0.0001),T early-staging(P=0.0066),N early-staging(P=0.0492),simple bone metastasis(other metastasis without bone metastasis(P=0.0104)VS other metastasis with bone metastases(P<0.0001)),and the low quantity of metastatic organs(P<0.0001)showed a improving survival.Multivariate COX model analysis showed that surgery was an independent prognostic factor for the OS of initial stage ? breast cancer(HR 0.271,95%CI 0.163-0.450,P<0.0001).In addition,other independent prognostic factors related to OS included tumor metastasis site(HR 3.756,95%ci 2.131-6.620,P<0.0001)and HER2(HR 0.584,95%CI 0.373-0.912,P=0.018).4.Subgroup analysis according to age,T stage,N stage,ER/PR,her-2,metastatic site,number of metastatic organs,endocrine therapy and o;ther factors showed that there was a survival benefit after surgery in all subgroups.However,in different molecular typing,the benefit was observed in Luminal type(P<0.0001)and her-2 positive type(P=0.0492),and no significant survival benefit was observed in and tri-negative type(P=0.174).Conclusion:For initial stage ? breast cancer,On the premise of systemic therapy,if the disease burden of the patient is significantly improved,the distant metastasis is well controlled,and the primary resection surgery can be evaluated to achieve RO resection,careful selection of primary resection can improve the prognosis of the patient to a certain extent.