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.
