Local Ablative Therapy in Oligometastatic Breast Cancer—Equipoise Persists
Menée à l'aide de données 2010-2020 portant sur 22 433 patientes atteintes d’un cancer du sein présentant un seul site métastatique (âge médian : 61 ans ; durée médiane de suivi : 61,5 mois), cette étude analyse la survie globale en fonction du traitement reçu (traitement chirurgical ou ablatif local, résection mammaire associée à une mastectomie ou résection mammaire seule)
In the US, up to 6% of newly diagnosed patients present with de novo metastatic disease (dnMBC). The role of locoregional management for these patients has been debated for more than 3 decades, with surgery traditionally reserved for palliation. In 2002, however, Khan and colleagues published US National Cancer Database (NCDB) data suggesting survival benefit after resection of the primary tumor, sparking numerous promising retrospective studies and a new era investigating whether local control, alongside systemic therapy, could improve survival.Prospective data have been less convincing. One of the earliest randomized clinical trials by Badwe and colleagues in 2015 showed no survival benefit to surgery compared with systemic therapy alone. The EA2108 trial similarly failed to show survival or quality of life advantages to early locoregional control. More recently, the JCOG1017 trial reinforced negative findings, as primary tumor resection did not prolong overall survival compared to systemic therapy alone, although some benefit was seen with single-organ metastasis.
JAMA Surgery , éditorial, 2026