Abstract：
BACKGROUND: We performed an updated meta-analysis to explore the value of locoregional surgery in de novo stage IV breast cancer patients.
METHODS: A literature search was conducted to identify randomized controlled trials comparing primary tumor resection with systemic therapy in de novo stage IV breast cancer. The hazard ratio (HR) of overall survival (OS), local relapse-free survival (LRFS), and distant relapse-free survival (DRFS) were estimated and pooled.
RESULTS: Six studies were eligible, including a total of 1368 patients. Both OS (HR = 0.86; 95 %CI: 0.77-0.96; p = 0.01; I2 = 45 %) and LRFS (HR = 0.35; 95 %CI: 0.20-0.62; p = 0.0003; I2 = 83 %) were significantly improved with locoregional surgery compared with systemic therapy alone. There was no significant difference in terms of DRFS (HR = 0.96; 95 %CI: 0.41-2.22; p = 0.92; I2 = 86 %). The OS benefit was more pronounced in hormone receptor-positive patients (HR = 0.79; p = 0.003) and HER2-negative patients (HR = 0.80; p = 0.003).
CONCLUSIONS: This study demonstrated that locoregional surgery conferred significant OS and LRFS benefits in de novo stage IV breast cancer patients and may serve as an alternative choice for selected patients.
METHODS: A literature search was conducted to identify randomized controlled trials comparing primary tumor resection with systemic therapy in de novo stage IV breast cancer. The hazard ratio (HR) of overall survival (OS), local relapse-free survival (LRFS), and distant relapse-free survival (DRFS) were estimated and pooled.
RESULTS: Six studies were eligible, including a total of 1368 patients. Both OS (HR = 0.86; 95 %CI: 0.77-0.96; p = 0.01; I2 = 45 %) and LRFS (HR = 0.35; 95 %CI: 0.20-0.62; p = 0.0003; I2 = 83 %) were significantly improved with locoregional surgery compared with systemic therapy alone. There was no significant difference in terms of DRFS (HR = 0.96; 95 %CI: 0.41-2.22; p = 0.92; I2 = 86 %). The OS benefit was more pronounced in hormone receptor-positive patients (HR = 0.79; p = 0.003) and HER2-negative patients (HR = 0.80; p = 0.003).
CONCLUSIONS: This study demonstrated that locoregional surgery conferred significant OS and LRFS benefits in de novo stage IV breast cancer patients and may serve as an alternative choice for selected patients.
摘要：
背景：我们进行了一项更新的荟萃分析，以探讨局部区域手术在初发IV期乳腺癌患者中的价值。
方法：进行了文献检索，以确定比较原发性肿瘤切除与全身治疗在新的IV期乳腺癌中的随机对照试验。总生存期（OS）的风险比（HR），局部无复发生存率（LRFS），和远端无复发生存期(DRFS)进行估计和汇总.
结果：六项研究符合资格，共1368名患者。与单独的全身治疗相比，局部手术的OS（HR=0.86；95CI：0.77-0.96；p=0.01；I2=45％）和LRFS（HR=0.35；95CI：0.20-0.62；p=0.0003；I2=83％）均显着改善。在DRFS方面没有显着差异（HR=0.96；95CI：0.41-2.22；p=0.92；I2=86％）。激素受体阳性患者（HR=0.79;p=0.003）和HER2阴性患者（HR=0.80;p=0.003）的OS获益更明显。
结论：这项研究表明，局部手术在新的IV期乳腺癌患者中赋予了显着的OS和LRFS益处，并且可以作为选定患者的替代选择。
方法：进行了文献检索，以确定比较原发性肿瘤切除与全身治疗在新的IV期乳腺癌中的随机对照试验。总生存期（OS）的风险比（HR），局部无复发生存率（LRFS），和远端无复发生存期(DRFS)进行估计和汇总.
结果：六项研究符合资格，共1368名患者。与单独的全身治疗相比，局部手术的OS（HR=0.86；95CI：0.77-0.96；p=0.01；I2=45％）和LRFS（HR=0.35；95CI：0.20-0.62；p=0.0003；I2=83％）均显着改善。在DRFS方面没有显着差异（HR=0.96；95CI：0.41-2.22；p=0.92；I2=86％）。激素受体阳性患者（HR=0.79;p=0.003）和HER2阴性患者（HR=0.80;p=0.003）的OS获益更明显。
结论：这项研究表明，局部手术在新的IV期乳腺癌患者中赋予了显着的OS和LRFS益处，并且可以作为选定患者的替代选择。
