start-ver=1.4
cd-journal=joma
no-vol=9
cd-vols=
no-issue=8
article-no=
start-page=5102
end-page=5107
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2020
dt-pub=202008
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Effect of local surgery on outcomes of stage IV breast cancer
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Metastatic breast cancer (MBC), including de novo stage IV, is regarded as being incurable and the mainstay of clinical management is systemic therapy. Traditionally, locoregional surgery is performed only for local control, such as to prevent ulceration and bleeding. In recent years, however, both retrospective and prospective studies have demonstrated the prognostic efficacy of primary surgery for de novo stage IV patients. Therefore, we conducted a meta-analysis to evaluate whether surgical therapy contributes to overall survival (OS) extension. We searched for clinical trials published in electronic databases (PubMed, Embase, and the Cochrane databases) and performed a meta-analysis of the data collected. There were five prospective randomized controlled phase III trials (RCTs). The results of three have been reported. According to our meta-analysis of these RCTs, primary surgery for de novo stage IV breast cancer patients significantly improves OS. However, the Tata trial showed that systemic therapy does not achieve a sufficient effect. Another trial, conducted in Turkey, had statistical shortcomings and patient randomization was not adequately performed The ABCSG (Austrian Breast and Colorectal Cancer Study Group) trial had too few subjects. Meta-analysis of 12 retrospective studies showed that patients with stage IV breast cancer receiving surgery as the initial treatment experienced longer OS (HR: 0.65, P<0.00001). Based on our meta-analysis of three reported 'RCTs, surgery as the primary treatment does not significantly impact the outcomes of de novo stage IV breast cancer patients. However, these trials had limitations. We await the results of the remaining two ongoing RCTs (ECOG 2108 and JCOG 1017). These trials are anticipated to resolve current controversies and provide many eagerly awaited answers.
en-copyright=
kn-copyright=

en-aut-name=TsukiokiTakahiro
en-aut-sei=Tsukioki
en-aut-mei=Takahiro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=

en-aut-name=ShienTadahiko
en-aut-sei=Shien
en-aut-mei=Tadahiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=

en-aut-name=DoiharaHiroyoshi
en-aut-sei=Doihara
en-aut-mei=Hiroyoshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=

affil-num=1
en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital
kn-affil=

affil-num=2
en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital
kn-affil=

affil-num=3
en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital
kn-affil=
en-keyword=Breast cancer
kn-keyword=Breast cancer
en-keyword=metastatic
kn-keyword=metastatic
en-keyword=stage IV
kn-keyword=stage IV
en-keyword=local therapy
kn-keyword=local therapy
en-keyword=locoregional therapy
kn-keyword=locoregional therapy
en-keyword=surgery
kn-keyword=surgery
en-keyword=survival
kn-keyword=survival
END

start-ver=1.4
cd-journal=joma
no-vol=9
cd-vols=
no-issue=8
article-no=
start-page=5028
end-page=5031
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2020
dt-pub=202008
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Oligometastases: history and future vision of breast cancer
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Oligometastases, oligo-recurrence, sync-oligometastases and metachronous oligometastases were proposed based on the spectrum theory. This review article, first, described the history of cancer theory. Second, we described the history of the concepts of oligometastases, oligo-recurrence and sync-oligometastases. Finally, we prospect future visions of breast cancer of oligometastases.
en-copyright=
kn-copyright=

en-aut-name=NiibeYuzuru
en-aut-sei=Niibe
en-aut-mei=Yuzuru
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=

en-aut-name=JinguKeiichi
en-aut-sei=Jingu
en-aut-mei=Keiichi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=

en-aut-name=OnishiHiroshi
en-aut-sei=Onishi
en-aut-mei=Hiroshi
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=

affil-num=1
en-affil=Department of Primary Care and Medical Education, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
kn-affil=

affil-num=2
en-affil=Department of Radiation Oncology, Graduate School of Medicine, Tohoku University
kn-affil=

affil-num=3
en-affil=Department of Radiology, Graduate School of Medicine, Yamanashi University
kn-affil=
en-keyword=Oligometastases
kn-keyword=Oligometastases
en-keyword=oligo-recurrence
kn-keyword=oligo-recurrence
en-keyword=sync-oligometastases
kn-keyword=sync-oligometastases
en-keyword=metachronous oligometastases
kn-keyword=metachronous oligometastases
en-keyword=breast cancer
kn-keyword=breast cancer
END

start-ver=1.4
cd-journal=joma
no-vol=9
cd-vols=
no-issue=8
article-no=
start-page=5063
end-page=5076
dt-received=
dt-revised=
dt-accepted=
dt-pub-year=2020
dt-pub=202008
dt-online=
en-article=
kn-article=
en-subject=
kn-subject=
en-title=
kn-title=Neurosurgery for brain metastasis from breast cancer
en-subtitle=
kn-subtitle=
en-abstract=
kn-abstract=Breast cancer is the most common malignancy among women worldwide, and the main cause of death in patients with breast cancer is metastasis. Metastasis to the central nervous system occurs in 10% to 16% of patients with metastatic breast cancer, and this rate has increased because of recent advancements in systemic chemotherapy. Because of the various treatments available for brain metastasis, accurate diagnosis and evaluation for treatment are important. Magnetic resonance imaging (MRI) is one of the most reliable preoperative examinations not only for diagnosis of metastatic brain tumors but also for estimation of the molecular characteristics of the tumor based on radiographic information such as the number of lesions, solid or ring enhancement, and cyst formation. Surgical resection continues to play an important role in patients with a limited number of brain metastases and a relatively good performance status. A single brain metastasis is a good indication for surgical treatment followed by radiation therapy to obtain longer survival. Surgical removal is also considered for two or more lesions if neurological symptoms are caused by brain lesions of >3 cm with a mass effect or associated hydrocephalus. Although maximal safe resection with minimal morbidity is ideal in the surgical treatment of brain tumors, supramarginal resection can be achieved in select cases. With respect to the resection technique, en bloc resection is generally recommended to avoid leptomeningeal dissemination induced by piecemeal resection. An operating microscope, neuronavigation, and intraoperative neurophysiological monitoring are essential in modern neurosurgical procedures, including tumor resection. More recently, supporting surgical instruments have been introduced. The use of endoscopic surgery has dramatically increased, especially for intraventricular lesions and in transsphenoidal surgery. An exoscope helps neurosurgeons to comfortably operate regardless of patient positioning or anatomy. A tubular retractor can prevent damage to the surrounding brain tissue during surgery and is a useful instrument in combination with both an endoscope and exoscope. Additionally, 5-aminolevulinic acid (5-ALA) is a promising reagent for photodynamic detection of residual tumor tissue. In the near future, novel treatment options such as high-intensity focused ultrasound (HIFU), laser interstitial thermal therapy (LITT), oncolytic virus therapy, and gene therapy will be introduced.
en-copyright=
kn-copyright=

en-aut-name=TomitaYusuke
en-aut-sei=Tomita
en-aut-mei=Yusuke
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=1
ORCID=

en-aut-name=KurozumiKazuhiko
en-aut-sei=Kurozumi
en-aut-mei=Kazuhiko
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=2
ORCID=

en-aut-name=FujiiKentaro
en-aut-sei=Fujii
en-aut-mei=Kentaro
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=3
ORCID=

en-aut-name=ShimazuYosuke
en-aut-sei=Shimazu
en-aut-mei=Yosuke
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=4
ORCID=

en-aut-name=DateIsao
en-aut-sei=Date
en-aut-mei=Isao
kn-aut-name=
kn-aut-sei=
kn-aut-mei=
aut-affil-num=5
ORCID=

affil-num=1
en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
kn-affil=

affil-num=2
en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
kn-affil=

affil-num=3
en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
kn-affil=

affil-num=4
en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
kn-affil=

affil-num=5
en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
kn-affil=
en-keyword=Metastatic brain tumor
kn-keyword=Metastatic brain tumor
en-keyword=breast cancer
kn-keyword=breast cancer
en-keyword=neurosurgical technique
kn-keyword=neurosurgical technique
END