The continuing conundrum in oligometastatic breast carcinoma: A real-world data

 

by Gangothri Selvarajan, Manikandan Dhanushkodi, Venkatraman Radhakrishnan, Carthikeyan Subramaniam Murali, Balasubramanian Ananthi, Priya Iyer, Arvind Krishnamurthy, Sridevi Velusamy, Selvaluxmy Ganesarajah, Tenali Gnana Sagar 

 

The Breast: Published: April 02, 2022

 

The optimal management in Oligometastatic (OM) breast carcinoma is not defined.

Objectives

To identify the prognostic factors influencing OM and the effect of Locoregional treatment (LRT) on survival in OM.

Methodology

Patients with ≤5 metastases and each with ≤ 5 cm size were defined as OM. Data of OM were extracted from the Institute Registry between 2012 and 2018. The impact of prognostic factors on survival was analysed by univariate and multivariate Cox regression. The Kaplan Meier survival curves were used to plot PFS and OS.

Results

There were 170 patients with OM. The median follow-up was 61 months. Median OS was 43.3 months. The median OS was 74 months in OMD vs 22.7 months in Oligorecurrent disease (ORD) with 5year OS rate of 55.3% vs 16.5% respectively. In the multivariate analyses of OMD both Ki67 ≤ 50% and hormone therapy (HT) showed significant favourable survival outcome. While premenopausal status and HT showed significant survival benefits in ORD. The worse survival outcome in ORD could be because of their aggressive biology and deficit in LRT compared to literature review. The prognostic factors were swayed by the uneven distribution of HR status, grade and Ki67.

Conclusion

The survival of OM was influenced by OMD, Ki67 ≤ 50%, premenopausal status and HT. The lesser survival rates of OM in the long term suggest the need for curative LRT to metastatic sites and primary tumor. The potential role of HT and targeted therapy with or without LRT need to be assessed in future randomised trials.