Effect of surgical treatment on patients with stage T3 or T4 triple-negative breast cancer: a SEER-based retrospective observational study

Background The use of surgery is controversial in patients with stage T3 or T4 triple-negative breast cancer (TNBC). We aimed to explore the effect of surgical treatment on overall survival (OS) of these patients. Methods A total of 2,041 patients were selected and divided into the surgical and non-surgical groups based on the Surveillance, Epidemiology, and End Results database from 2010 to 2018. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to balance covariates between different groups. The OS of the two groups were assessed by Kaplan–Meier survival curves and Cox proportional hazards regression models. Results A total of 2,041 patients were included in the study. After PSM and IPTW, baseline characteristics of the matched variables were fully balanced. Kaplan–Meier survival curves showed that the median survival time and OS of TNBC patients with stage T3 or T4 in the surgical group were significantly improved compared with those in the non-surgical group. Multivariate Cox proportional hazards regression analysis showed that surgery was a protective factor for prognosis. Conclusion Our study found that surgery prolonged the median survival and improved OS compared with the non-surgical group of TNBC patients with stage T3 or T4.

[1]  Ying Lin,et al.  Dissecting the role of cancer‐associated fibroblast‐derived biglycan as a potential therapeutic target in immunotherapy resistance: A tumor bulk and single‐cell transcriptomic study , 2023, Clinical and translational medicine.

[2]  Yongheng Chen,et al.  Recent advances in therapeutic strategies for triple-negative breast cancer , 2022, Journal of Hematology & Oncology.

[3]  Z. Nahleh,et al.  Triple Negative Breast Cancer: Updates on Classification and Treatment in 2021 , 2022, Cancers.

[4]  Ting Gao,et al.  Therapeutic Landscape of Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer , 2022, Cancer control : journal of the Moffitt Cancer Center.

[5]  Wei Zhang,et al.  Metastatic Pattern Discriminates Survival Benefit of Type of Surgery in Patients With De Novo Stage IV Breast Cancer Based on SEER Database , 2021, Frontiers in Surgery.

[6]  J. Hartman,et al.  Molecular analyses of triple-negative breast cancer in the young and elderly , 2021, Breast cancer research : BCR.

[7]  A. Jemal,et al.  Cancer Statistics, 2021 , 2021, CA: a cancer journal for clinicians.

[8]  Yuxiang Lin,et al.  Impact of breast surgery on survival of patients with stage IV breast cancer: a SEER population-based propensity score matching analysis , 2020, PeerJ.

[9]  J. L. da Silva,et al.  Triple negative breast cancer: A thorough review of biomarkers. , 2019, Critical reviews in oncology/hematology.

[10]  A. Damjanović,et al.  Mechanisms of Chemotherapy Resistance in Triple-Negative Breast Cancer—How We Can Rise to the Challenge , 2019, Cells.

[11]  T. Gillespie,et al.  Surgery and survival in patients with stage IV breast cancer , 2019, The breast journal.

[12]  R. Greil,et al.  Impact of Breast Surgery in Primary Metastasized Breast Cancer: Outcomes of the Prospective Randomized Phase III ABCSG-28 POSYTIVE Trial. , 2019, Annals of surgery.

[13]  R. Greil,et al.  Impact of Breast Surgery in Primary Metastasized Breast Cancer: Outcomes of the Prospective Randomized Phase III ABCSG-28 POSYTIVE Trial , 2019, Annals of surgery.

[14]  Xin Hu,et al.  Genomic and Transcriptomic Landscape of Triple-Negative Breast Cancers: Subtypes and Treatment Strategies. , 2019, Cancer cell.

[15]  K. Polyak,et al.  Insights into Molecular Classifications of Triple-Negative Breast Cancer: Improving Patient Selection for Treatment. , 2019, Cancer discovery.

[16]  Eric P. Winer,et al.  Breast Cancer Treatment: A Review , 2019, JAMA.

[17]  G. Babiera,et al.  Prognostic Impact of 21-Gene Recurrence Score in Patients With Stage IV Breast Cancer: TBCRC 013. , 2016, Journal of Clinical Oncology.

[18]  J. Iqbal,et al.  Ten-year survival in women with primary stage IV breast cancer , 2016, Breast Cancer Research and Treatment.

[19]  D. Ajarim,et al.  Impact of Surgery on Survival in Stage IV Breast Cancer , 2016, The breast journal.

[20]  I. Mittra,et al.  Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial. , 2015, The Lancet. Oncology.

[21]  C. Perou,et al.  Age-specific changes in intrinsic breast cancer subtypes: a focus on older women. , 2014, The oncologist.

[22]  S. Spiegel,et al.  Resection of the primary tumor improves survival in metastatic breast cancer by reducing overall tumor burden. , 2013, Surgery.

[23]  M. Barry,et al.  Meta-Analysis to Determine if Surgical Resection of the Primary Tumour in the Setting of Stage IV Breast Cancer Impacts on Survival , 2013, Annals of Surgical Oncology.

[24]  B. Sharma,et al.  An Open Label Randomised Controlled Trial of Probiotics for Primary Prophylaxis of Hepatic Encephalopathy in Patients with Cirrhosis , 2013 .

[25]  P. Austin Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples , 2009, Statistics in medicine.

[26]  Peter C Austin,et al.  The performance of different propensity score methods for estimating marginal hazard ratios , 2007, Statistics in medicine.

[27]  E. Mittendorf Resection of the primary tumor improves survival in metastatic breast cancer by reducing overall tumor burden , 2014 .

[28]  Robert C. Wolpert,et al.  A Review of the , 1985 .