{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:17:53Z","timestamp":1783351073015,"version":"3.54.6"},"reference-count":0,"publisher":"International Institute of Anticancer Research","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CDP"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:p>Background\/Aim: \nThe prognostic impact of local treatment (LT) of the primary tumor in patients with de novo metastatic breast cancer (dnMBC) remains unclear. We conducted a systematic review and meta-analysis to evaluate whether surgery and\/or radiotherapy of the primary tumor improves overall survival (OS).\nMaterials and Methods: \nElectronic databases (PubMed, Embase, Cochrane) were searched up to March 2025 for studies comparing LT (surgery and\/or radiotherapy) plus systemic therapy versus systemic therapy alone. Hazard ratios (HRs) for OS were pooled using a random-effects model. Subgroup analyses were performed by study design, treatment modality, biological subtype, and metastatic site. Heterogeneity was quantified using I\u00b2, and meta-regression was used to explore potential moderators.\nResults: \nTwenty studies, including randomized controlled trials (RCTs) and retrospective studies, were included. In pooled analyses, LT was associated with improved OS compared to systemic therapy alone. [HR=0.62; 95% confidence interval (CI)=0.52\u20130.75; p&lt;0.0001; I\u00b2=97.3%]. In RCTs, the difference was not significant (HR=0.91; 95% CI=0.67\u20131.25; p=0.57). Surgery of the primary tumor was associated with improved OS (pooled HR=0.62; 95% CI=0.52\u20130.75). In the radiotherapy-only subgroup, based on a very limited number of heterogeneous retrospective studies, no survival benefit was observed (pooled HR=1.51; 95% CI=0.87\u20132.63). Given the very limited number of studies and the substantial heterogeneity (I\u00b2=91.5%), these findings need to be interpreted with caution. Subgroup analyses showed a non-significant trend in hormone receptor\u2013positive disease (HR=0.78; 95% CI=0.58\u20131.04) and no benefit in HER2-positive (HR=0.90; 95% CI=0.61\u20131.33) or liver-limited disease (HR=1.17; 95% CI=0.77\u20131.78). No covariates were significantly associated with OS in meta-regression.\nConclusion: \nAlthough pooled analyses suggest an association between local treatment and improved OS, this effect appears largely driven by retrospective data and is not confirmed in randomized trials.<\/jats:p>","DOI":"10.21873\/cdp.10562","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:51:52Z","timestamp":1783349512000},"page":"619-629","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Local Treatment of the Primary Tumor on Overall Survival in De Novo Metastatic Breast Cancer: A Systematic Review and Meta-analysis"],"prefix":"10.21873","volume":"6","author":[{"given":"LUISANA","family":"SISCA","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARIAM","family":"GRAZIA POLITO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MICHELE","family":"IULIANI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GIUSEPPE","family":"TONINI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FRANCESCO","family":"PANTANO","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"9336","published-online":{"date-parts":[[2026,7,1]]},"container-title":["Cancer Diagnosis &amp; Prognosis"],"original-title":[],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:51:53Z","timestamp":1783349513000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cancerdiagnosisprognosis.org\/article\/624\/impact-of-local-treatment-of-the-primary-tumor-on-overall-survival-in-de-novo-metastatic-breast-cancer-a-systematic-review-and-meta-analysis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,7,1]]},"published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.21873\/cdp.10562","relation":{},"ISSN":["2732-7787"],"issn-type":[{"value":"2732-7787","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}