In addition to targeted medication, adjuvant therapy, surgery improves survival in stage IV disease
TUESDAY, April 2, 2019 (HealthDay News) — For patients with human epidermal growth factor receptor 2-positive (HER2+) stage IV breast cancer, surgery is associated with improved survival, according to a study presented at the annual meeting of the American Association for Cancer Research, held from March 29 to April 3 in Atlanta.
Ross Mudgway, from the University of California Riverside School of Medicine, and colleagues examined the impact of primary tumor resection on survival in 3,231 women with HER2+ stage IV breast cancer.
The researchers found that 35.0 and 65.0 percent of patients underwent primary site surgery and did not have surgery, respectively. The odds of having surgery were increased for those with Medicare/other government or private insurance versus no insurance/Medicaid (odds ratios, 1.36 and 1.93, respectively), as well as for patients receiving radiation (odds ratio, 2.10), chemotherapy/immunotherapy (odds ratio, 1.99), and endocrine therapy (odds ratio, 1.73). The likelihood of having surgery was lower for non-Hispanic black versus non-Hispanic white patients (odds ratio, 0.68) and those treated in academic/research versus community programs (odds ratio, 0.67). Lower mortality hazard ratios were seen in association with insurance, receipt of chemotherapy/immunotherapy, and receipt of endocrine therapy (hazard ratios, 0.36, 0.76, and 0.70, respectively). Surgery was associated with improved survival versus no surgery in propensity score analysis (hazard ratio, 0.56).
“In addition to standard HER2 targeted medications and other adjuvant therapy, if a woman has stage 4 HER2+ breast cancer, surgery to remove the primary breast tumor should be considered,” a coauthor said in a statement.
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