Selected Patients With Peritoneal Metastases From Breast Cancer May Benefit From Cytoreductive Surgery: The Results of a Multicenter Survey

Frontiers in Oncology

Gianluca Baiocchi¹  Andrea Di Giorgio²  Alessandra Spagnoli³  Francesco Di Marzo⁴  Franco Iafrate⁵  Enrico Maria Pasqual⁶  Gianmaria Fiorentini⁷  Salvatore Asero⁸  Bianca Sollazzo⁹  Giuseppe D’Ermo⁹  Daniele Biacchi⁹  Maurizio Cardi⁹  Paolo Sammartino⁹  Roberta Gelmini^1,10  Mario Valle^1,11  Marco Vaira^1,12  Marc Pocard^1,13  Rea Lo Dico^1,14 

[1] 0Clinical and Experimental Sciences Department, University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Cremona, Italy;1Surgery of Peritoneum and Retroperitoneum Unit, Istituti Ricerca e Cura a Carattere Scientifico (IRCCS) Fondazione Policlinico Universitario A. Gemelli, Rome, Italy;2Public Health and Infectious Diseases Department, Statistics Unit, Sapienza University of Rome, San Donato, Italy;3General Surgery Department, Ospedale Valtiberina, Unità Sanitaria Locale (USL) Toscana Sud-Est, Sansepolcro, Italy;4Department of Radiology and Oncology, Sapienza University of Rome, Rome, Italy;Advanced Oncologic Surgery Unit, Dipartimento Area Medica (DAME) University of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC) Udine, Italy;Department of Oncology, Azienda Ospedaliera (AO) Ospedali Marche Nord, Pesaro, Italy;Department of Oncology, Surgical Oncology Unit, Azienda Ospedaliera di Rilievo e di Alta Specializzazione Garibaldi,Catania, Italy;Department of Surgery Pietro Valdoni, Sapienza University of Rome, Rome, Italy;Department of Surgery, General and Oncologic Surgery Unit, Azienda Ospedaliera Universitaria (AOU) Modena, University of Modena and Reggio Emilia, Modena and Reggio Emilia, Italy;Peritoneal Tumors Unit, Istituto Nazionale Tumori Regina Elena, Rome, Italy;Surgical Oncology Unit, Istituto Tumori di Candiolo, Turin, Italy;University of Paris, Unité Mixte de Recherche (UMR) 1275 CArcinose et pathologies du Péritoine (CAP) Paris Tech Carcinomatosis Peritoneum Paris Technology, Digestive and Hepato-Biliary Surgery Department, Pitié Salpetrière Hospital, Assistance Publique Hôpitaux de Paris, Paris, France;University of Paris, Unité Mixte de Recherche (UMR) 1275 CArcinose et pathologies du Péritoine (CAP) Paris Tech Lariboisière Carcinomatosis Peritoneum Paris Technology, Digestive and Oncological Surgery Department, Saint Louis Hospitals, Assistance Publique Hôpitaux de Paris, Paris, France;

关键词: breast cancer;    peritoneal metastases;    cytoreductive surgery;    oligometastatic disease;    ascites treatment;   

DOI  :  10.3389/fonc.2022.822550

来源: DOAJ

【 摘 要 】

BackgroundEven though breast cancer is the most frequent extra-abdominal tumor causing peritoneal metastases, clear clinical guidelines are lacking. Our aim is to establish whether cytoreductive surgery (CRS) could be considered in selected patients with peritoneal metastases from breast cancer (PMBC) to manage abdominal spread and allow patients to resume or complete other medical treatments.MethodsWe considered patients with PMBC treated in 10 referral centers from January 2002 to May 2019. Clinical data included primary cancer characteristics (age, histology, and TNM) and data on metastatic disease (interval between primary BC and PM, molecular subtype, other metastases, and peritoneal spread). Overall survival (OS) was estimated using the Kaplan–Meier method. Univariate and multivariable data for OS were analyzed using the Cox proportional hazards model.ResultsOf the 49 women with PMBC, 20 were treated with curative aim (CRS with or without HIPEC) and 29 were treated with non-curative procedures. The 10-year OS rate was 27%. Patients treated with curative intent had a better OS than patients treated with non-curative procedures (89.2% vs. 6% at 36 months, p < 0.001). Risk factors significantly influencing survival were age at primary BC, interval between BC and PM diagnosis, extra-peritoneal metastases, and molecular subtype.ConclusionsThe improved outcome in selected cases after a multidisciplinary approach including surgery should lead researchers to regard PMBC patients with greater attention despite their scarce epidemiological impact. Our collective efforts give new information, suggest room for improvement, and point to further research for a hitherto poorly studied aspect of metastatic BC.

【 授权许可】

Unknown