Objectives: This study aimed to evaluate the impact of locoregional resection and radiotherapy on the prognosis of Chinese women with stage IV breast cancer. Methods: The retrospective study included Chinese patients with de novo stage IV breast cancer in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, between January 1, 2001, and December 31, 2016. The patients were classified into surgery and nonsurgery groups. Overall survival (OS) and distant progression-free survival (DPFS) were evaluated at the last follow-up. Results: Of the 157 patients, 66 (42.0%) underwent surgery and 52 (33.1%) received locoregional radiotherapy. The follow-up time ranged from 3 to 180 months. The median patient follow-up was 54.5 months. The patients in the surgery group had longer 5-year OS and 5-year DPFS compared with the patients in the nonsurgery group. DPFS was also significantly longer in patients who received radiotherapy. Two factors proved to be associated with survival: response to systemic therapy and surgical treatment. Multivariate analysis also showed that the progestogen receptor status significantly influenced the DPFS. Conclusion: Locoregional surgery and radiotherapy of primary tumor might be beneficial for Chinese patients with stage IV breast cancer. It proposed that surgical resection for selected stage IV breast cancer patients. (C) 2018 S. Karger AG, Basel