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. 2023 Feb:67:14-20.
doi: 10.1016/j.breast.2022.12.007. Epub 2022 Dec 14.

Survival and prognostic factors in oligometastatic breast cancer

Annemiek van Ommen-Nijhof  1 , Tessa G Steenbruggen  2 , Laura Capel  3 , Michel Vergouwen  4 , Marie-Jeanne T Vrancken Peeters  5 , Terry G Wiersma  6 , Gabe S Sonke  7
Affiliations

Survival and prognostic factors in oligometastatic breast cancer

Annemiek van Ommen-Nijhof et al. Breast. 2023 Feb.

Abstract

Background: Guidelines for oligometastatic breast cancer (OMBC) propagate multimodality treatment including polychemotherapy and local ablative treatment (LAT) of all lesions. The aim of this approach is prolonged disease remission, or even cure. Long-term outcomes in OMBC and factors associated with prognosis are largely unknown, due to the rarity of this condition. We report overall survival (OS), event-free survival (EFS), and prognostic factors in a large real-world cohort of patients with OMBC.

Methods: Patients with breast cancer and 1-3 distant metastatic lesions, treated in the Netherlands Cancer Institute between 1997 and 2020, were identified via text mining of medical files. We collected patient, tumor and treatment characteristics. The Kaplan-Meier method was used to calculate OS and EFS estimates, and Cox regression analyses to assess prognostic factors.

Results: The cohort included 239 patients, of whom 54% had ERpos/HER2neg, 20% HER2pos and 20% triple negative disease. Median follow-up was 88.0 months (95% confidence interval (CI) 82.9-93.1) during which 107 patients died and 139 developed disease progression/recurrence; median OS was 93.0 months (95%CI 66.2-119.8). Factors associated with OS in multivariable analysis were subtype, disease-free interval and radiologic response to first-line systemic therapy; LAT was associated with EFS, but not OS.

Conclusions: In this large real-world cohort of patients with OMBC, OS and EFS compare favorably to survival in the general MBC population. Radiologic complete response to first-line systemic therapy was associated with favorable OS and EFS, indicating the importance of early optimal systemic therapy. The value of LAT in OMBC requires further study.

Keywords: Breast cancer; Chemotherapy; Local ablative therapy; Multimodality treatment; Oligometastasis.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: GS reports the following competing interests: Consulting or Advisory Role - Biovica (Inst); Novartis (Inst); Seattle Genetics (Inst). Research Funding - Agendia (Inst); AstraZeneca/Merck (Inst); Merck Sharp & Dohme (Inst); Novartis (Inst); Roche (Inst). AvON, TS, LC, MV, MVP, TW report no competing interests.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Flow chart of patient selection.
Fig. 2
Fig. 2
Overall (A) and event-free (B) survival in the whole cohort. CI, confidence interval; EFS, event-free survival; OMBC, oligometastatic breast cancer; yr, year.
Fig. 3
Fig. 3
Factors associated with overall (A) and event-free survival (B) in multivariable analysis.
See this image and copyright information in PMC

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