Quality of life in patients with de novo metastatic breast cancer undergoing locoregional surgery: A prospective observational study.

Abstract

e13044 Background: Breast cancer remains the most frequent type of cancer in women, with de novo metastatic breast cancer (dnMBC) accounting for approximately 10% of patients. Advances in diagnosis and treatment of breast cancer have led to an increase in cancer survival, resulting in quality of life (QoL) improvement. However, there are few reports on whether local treatment improves quality of life for de novo metastatic breast cancer (dnMBC). Aim: To evaluate QoL in dnMBC patients since randomization using scores from the FACT-B health survey. Settings and design: This study was designed as a prospective observational research project and was approved by the Ethics Committee of the Ethics Committee of Cangzhou Clinical College of Integrated Traditional Chinese and Western Medicine of Hebei Medical University (NO.20200212). Methods: Eighty-six patients with dnMBC were randomised to surgery of the primary tumor followed by systemic therapy (surgery group) or to primary systemic therapy without surgery (non-surgery group). QoL analyses covering the results at baseline, 6,12,18,24 and 30 months follow up of 81 (94%) patients, was assessed with the Functional Assessment of Chronic Illness Therapy General Questionnaire, including Breast Cancer Supplement (FACT-B) questionnaires. Inclusion criteria were: did not meet the diagnostic criteria of de novo metastatic breast cancer and patients could not cooperate QoL was assessed by FACT-BTOI variables evaluated at 6 time point. Average FACT-B TOI score was measured by the prorated aggregate score of 37 items from the FACT-B. The Wilcoxon rank sum test was used to compare the differences at each time point. The level for significance was set at p<0.05.All analyses were performed with STATA 16. Results: From 2019 to 2021,a total of 86 dnMBC patients were selected and recruited in Department of breast surgery of our hospitals. Among them, 81 completed FACT-B questionnaires and their data were analyzed. Forty-one (95%) patients in the surgery group and 40 (93%) in the non-surgery group were included in the QoL analyses. A total of 362 QoL questionnaires were analyzed, 81(100%) at baseline, and 73(90%), 64(79%), 58(72%), 47(58%), 39(48%) at 6,12,18,24, and 30 months, respectively. The average FACT-B TOI scores showed no statistically significant difference between the two groups at each time point, with a P value of 0.09 at baseline, and 0.47,0.67,0.36,0.45,0.34 at 6,12,18,24, and 30 months, respectively. No significant difference was found in QOL evaluation between the two groups. Conclusions: Our prospective randomized trial showed that compared with non-surgery counterparts, locoregional surgery does not improve QoL of patients with dnMBC. Clinical trial information: 20200212.