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A student at the University of California, Riverside, presented the results of the research at the annual meeting of the American Association for Cancer (AACR) in Atlanta, demonstrating that surgery was badociated with higher survival rates at patients with stage 4 HER2-positive bad cancer. with those who have not had surgery.
HER2 protein, or human epidermal growth factor receptor 2, may play a role in the development of bad cancer.
"Between 20% and 30% of newly diagnosed stage 4 bad cancer cases are HER2-positive," said Ross Mudgway, lead author of the study and a third-year student at UCR School of Medicine. "This form of bad cancer once had poor results, but in recent years, advances in targeted therapy have improved survival."
Mudgway explained at the meeting that in recent years, most patients with HER2-positive bad cancer have been treated with systemic therapy, which could include chemotherapy, targeted therapy or endocrine therapy.
"Surgical interventions are sometimes offered to these patients, but previous research on improving surgical survival has yielded mixed results," he said.
According to Mudgway and Dr. Sharon Lum, lead author, professor in the Department of Surgery-Division of Surgical Oncology and Medical Director of the Breast Health Center of Loma Linda University, HER2 status has been reported in large sets of registry data since 2010, but the impact of surgery on this type of bad cancer has not been well documented in hospital systems. The researchers conducted a retrospective cohort study of 3,231 women with stage 4 HER2-positive bad cancer, using records from the 2010-12 national cancer database.
They found that 89.4% of women had received chemotherapy or targeted therapies, 37.7% had received endocrine therapy and 31.8% had received radiation therapy. In total, 1,130 women, or 35%, were operated on.
The researchers found that surgery was badociated with an increased chance of survival of 44%, baduming that the majority of them were also following systemic therapy.
"This suggests that in addition to standard HER2-targeting drugs and other adjunctive therapies, if a woman has stage 4 HER2-positive bad cancer, surgery to remove the primary bad tumor should to be considered, "Lum said.
The study also examined factors badociated with the receipt of a surgical procedure and found that women receiving Medicare or private insurance were more likely to be operated on and less likely to die of their illness than those benefiting from Medicaid or having no insurance. White women were also more likely than non-Hispanic black women to be operated on and less likely to die from their cancer.
"These findings suggest disparities in health care due to racial and socio-economic factors, and need to be addressed," said Mudgway.
According to Mudgway and Lum, many factors can help the doctor decide on the advisability of recommending surgery, including other chronic diseases in the patient, the response to other forms of treatment and life expectancy in general.
"Our findings must be viewed in the context of all other factors," said Mudgway. "For patients, the decision to have bad surgery, especially a mastectomy, can often change their lives because it affects their physical and emotional health.The patient must decide whether or not to undergo an intervention. surgical. "
The study was self-funded by the Department of Surgery of the University of Loma Linda.
Eileen Loftus of AACR contributed significantly to this article.
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