A surgical oncologist honors an admirable doctor in the field who refuses to falter in the face of challenges in order to do exhaust every opportunity possible to improve the lives of patients with metastatic breast cancer.
As surgeons, we tend to concentrate on patients with curable breast cancer and when faced with metastatic breast cancer, we typically step back and refer the patients to the medical oncologist.
Dr. Soran is one of the pioneers who decided to explore further the role of surgery in the treatment of patients with metastatic breast cancer. Maybe surgically removing the primary site of breast cancer could slow the disease and progression of the disease. For that reason, he embarked on a series of studies aiming to analyze this working theory.
In collaboration with a group of cancer specialists in Turkey and in the U.S., Dr. Soran enrolled 274 patients with metastatic breast cancer at presentation in a randomized trial, in which roughly half the patients underwent surgery to remove the site of primary disease followed by systemic therapy, and half were treated by standard systemic therapy with no surgery.
The study demonstrates that in a subgroup of patients with bone-only metastatic disease, which is associated with a longer life expectancy than visceral metastatic disease, the five-year median follow up was better after the primary site was removed surgically, confirming the working hypothesis. This is now one of the seminal studies quoted when surgery for metastatic disease is being considered.
As a result of this first study, the group led by Dr. Soran has now completed a second study, enrolling 505 patients with bone-only metastases and randomizing them to surgical removal of the local and regional disease (breast and lymph nodes) and systemic therapy before or after the surgery or systemic therapy with no surgery. The results confirmed again a better survival within the surgery group as early as after three years.
Finally, Dr. Soran has pioneered genomic analysis of metastatic breast cancer in order to potentially identify treatable mutations.
For his dedication to metastatic breast cancer from a surgical aspect, I believe that Dr. Soran is a hero well suited for this award.
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