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Medline ® Abstract for Reference 36

of 'The role of local therapies in metastatic breast cancer'

Disease-free survival after resection of lung metastases in patients with breast cancer.
Ludwig C, Stoelben E, Hasse J
Eur J Surg Oncol. 2003;29(6):532.
AIMS: Metastatic breast cancer is a systemic disease. The discussion concerning the resection of lung metastases in patients with breast cancer is controversial.
METHODS: Retrospective analysis of 25 patients with suspected pulmonary metastases operated between March 1989 and September 1998. Survival probabilities and disease-free survival was analysed using the Kaplan-Meier method and the log-rank test.
RESULTS: The median survival rate after resection of lung metastases for the 21 patients was 96.9 months. The disease-free survival (DFS) after resection of lung metastases was 27.6 months. Survival was not influenced by the receptor status, lymph node involvement, number of lung metastases (p=0.8) or the disease-free interval (DFI) (0.59). DFS was, however, influenced by the DFI. With a DFI of<2 years survival was 8.5 months, whereas with a DFI>2 years it was 36.1 months (p=0.012). The DFS was influenced, but not statistically significant, by the number of lung metastases (n=1/n>1). The median DFS was 28.8 months with one metastasis and 13.1 months with multiple metastases (p=0.29).
CONCLUSIONS: The indication to remove solitary lung metastases in patients with previous breast cancer is supported by these findings. Especially when the disease-free interval is greater than two years.
Division of Thoracic Surgery, University Hospital, Freiburg, Germany. ludwig@chll.ukl.uni-freiburg.de