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開催概要
開催回
第58回・2020年・京都
 

Stage IV乳癌の治療、原発巣切除を含め、予後改善についての検討

演題番号 : WS9-6

[筆頭演者]
増岡 秀次:1 
[共同演者]
三神 俊彦:1、下川原 出:1、浅石 和昭:1、森 満:2

1:札幌ことに乳腺クリニック・外科、2:北海道千歳リハビリテーション大学

 

[Introduction] Primary lesion resection in patients with stage IV breast cancer (s-IV bc) has been shown to possess a significant prolongation effect on survival time in some reports, but, it was not validated in other reports. Recently, there is a remarkable progress in treatment for s-IV bc such as the emergence of immune check inhibitors and companion diagnostic agents. Consequently, treatment for s-IV bc needs to be reconsidered.
[Purpose] We investigated the prognosis of patients with s-IV bc, according to treatment including primary lesion resection.
[Subjects and Methods] We targeted 5,241 cases with primary bc who underwent treatment at our hospital by 2018 for analysis. Among them, 54 cases (1.0%) with s-IV bc were accounted. Their age range was from 21 to 92 years (mean=52.5). The average observation period was 10.4 years. The Kaplan-Meier method and the Log-rank test was used.
[Results and Discussion] Systemic drug therapy has been increasingly given for s-IV bc. The advent of various molecularly targeted drugs such as CDK4/6 inhibitors has brought great benefits in therapy. Occurrence of pCR, even in patients with distant metastases, has been observed in the combination therapy of molecularly targeted drugs in HER2-positive cases. For the cases effectively treated, primary lesion resection has been optionally conducted. The average age of the cases surgically treated was 52 years, and 40% of them were under 45 years old. In site of single metastasis, bone, lung, and liver accounted for about 30%, 20%, and 20%, respectively, and multiple metastases accounted for 30%. Their 5- and 10-year survival rate was 50% and 35%, respectively. Their 50% survival rate was 5 years. Randomized controlled trials are required to obtain the convincing evidence of the surgery in improved survival. With the advent of new therapeutic agents such as PARP inhibitors and immune check inhibitors for hereditary bc, therapy for patients with s-IV bc will be different in the future.

キーワード

臓器別:乳腺

手法別:集学的治療

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