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van Ommen-Nijhof A, Steenbruggen TG, Capel L, Vergouwen M, Vrancken Peeters MJT, Wiersma TG, Sonke GS. Survival and prognostic factors in oligometastatic breast cancer. Breast 2022; 67:14-20. [PMID: 36549169 PMCID: PMC9795523 DOI: 10.1016/j.breast.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Guidelines for oligometastatic breast cancer (OMBC) propagate multimodality treatment including polychemotherapy and local ablative treatment (LAT) of all lesions. The aim of this approach is prolonged disease remission, or even cure. Long-term outcomes in OMBC and factors associated with prognosis are largely unknown, due to the rarity of this condition. We report overall survival (OS), event-free survival (EFS), and prognostic factors in a large real-world cohort of patients with OMBC. METHODS Patients with breast cancer and 1-3 distant metastatic lesions, treated in the Netherlands Cancer Institute between 1997 and 2020, were identified via text mining of medical files. We collected patient, tumor and treatment characteristics. The Kaplan-Meier method was used to calculate OS and EFS estimates, and Cox regression analyses to assess prognostic factors. RESULTS The cohort included 239 patients, of whom 54% had ERpos/HER2neg, 20% HER2pos and 20% triple negative disease. Median follow-up was 88.0 months (95% confidence interval (CI) 82.9-93.1) during which 107 patients died and 139 developed disease progression/recurrence; median OS was 93.0 months (95%CI 66.2-119.8). Factors associated with OS in multivariable analysis were subtype, disease-free interval and radiologic response to first-line systemic therapy; LAT was associated with EFS, but not OS. CONCLUSIONS In this large real-world cohort of patients with OMBC, OS and EFS compare favorably to survival in the general MBC population. Radiologic complete response to first-line systemic therapy was associated with favorable OS and EFS, indicating the importance of early optimal systemic therapy. The value of LAT in OMBC requires further study.
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Affiliation(s)
- Annemiek van Ommen-Nijhof
- Department of Medical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, PO Box 90203, 1006 BE, Amsterdam, the Netherlands
| | - Tessa G. Steenbruggen
- Department of Medical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, PO Box 90203, 1006 BE, Amsterdam, the Netherlands,Department of Internal Medicine, St Antonius Hospital, PO Box 2500, 3430 EM, Nieuwegein, the Netherlands
| | - Laura Capel
- Department of Internal Medicine, St Antonius Hospital, PO Box 2500, 3430 EM, Nieuwegein, the Netherlands
| | - Michel Vergouwen
- Department of Biometrics, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, PO Box 90203, 1006 BE, Amsterdam, the Netherlands
| | - Marie-Jeanne T. Vrancken Peeters
- Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, PO Box 90203, 1006 BE, Amsterdam, the Netherlands,Department of Surgery, Amsterdam University Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands
| | - Terry G. Wiersma
- Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, PO Box 90203, 1006 BE, Amsterdam, the Netherlands
| | - Gabe S. Sonke
- Department of Medical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, PO Box 90203, 1006 BE, Amsterdam, the Netherlands,Department of Medical Oncology, Amsterdam University Medical Center, PO Box 22660, 1100 DD, Amsterdam, the Netherlands,Corresponding author. Department of Medical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, PO Box 90203, 1006 BE, Amsterdam, the Netherlands. @annemiekvon
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