Identifying the potential long-term survivors among breast cancer patients with distant metastasis

Lee, E.S.; Jung, So‐Youn; Kim, Jae-Yeon; Kim, J.J.; Yoo, Tae Kyung; Kim, Young-Gi; Lee, K.S.; Kim, E.K.; Min, Jeong Jin; Han, Wonshik; Noh, Dong‐Young; Moon, Hyeong‐Gon

doi:10.1093/annonc/mdw036

Cited by 34 publications

(23 citation statements)

References 28 publications

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“…MBC remains an incurable disease wit poor prognosis among breast cancer [ 25 ]. Our study showed that almost half of MBC patients (46.5%) would die of cancer within 3 years, which was concordant with the previuos report [ 10 ]. The purpose of treatment for MBC is to reduce tumour burden, relieve symptoms, and improve the quality of life [ 3 ].…”

Section: Discussionsupporting

confidence: 93%

“…For most of patients with MBC, metastasis disease would progress rapidly involving multiple organ and cause destruction of organ function in a short time [ 3 , 9 ]. Meanwhile, a part of MBC patients was reported to achieve tumour remission with systematic therapy and have a relatively prolonged survival [ 10 ]. Several population-based studies have shown that MBC patients with longer metastasis-free interval (MFI > 5 years) had a superior prognosis to those with a shorter MFI (MFI < 5 years) [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Score for the Survival Probability in Metastasis Breast Cancer: A Nomogram-Based Risk Assessment Model

et al. 2018

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PurposeSurvival of metastatic breast cancer (MBC) patient remains unknown and varies greatly from person to person. Thus, we aimed to construct a nomogram to quantify the survival probability of patients with MBC.Materials and MethodsWe had included 793 MBC patients and calculated trends of case fatality rate by Kaplan-Meier method and joinpoint regression. Six hundred thirty-four patients with MBC between January 2004 and July 2011 and 159 patients with MBC between August 2011 and July 2013 were assigned to training cohort and internal validation cohort, respectively. We constructed the nomogram based on the results of univariable and multivariable Cox regression analyses in the training cohort and validated the nomogram in the validation cohort. Concordance index and calibration curves were used to assess the effectiveness of nomogram.ResultsCase fatality rate of MBC was increasing (annual percentage change [APC], 21.6; 95% confidence interval [CI], 1.0 to 46.3; p < 0.05) in the first 18 months and then decreased (APC, -4.5; 95% CI, -8.2 to -0.7; p < 0.05). Metastasis-free interval, age, metastasis location, and hormone receptor status were independent prognostic factors and were included in the nomogram, which had a concordance index of 0.69 in the training cohort and 0.67 in the validation cohort. Calibration curves indicated good consistency between the two cohorts at 1 and 3 years.ConclusionIn conclusion, the fatality risk of MBC was increasing and reached the summit between 13th and 18th month after the detection of MBC. We have developed and validated a nomogram to predict the 1- and 3-year survival probability in MBC.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Score for the Survival Probability in Metastasis Breast Cancer: A Nomogram-Based Risk Assessment Model

et al. 2018

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“…As previously reported91422, we found that patients with bone metastasis showed the best prognosis, and patients with brain metastasis showed worst prognosis. One of the reasons why women with brain metastasis had an unfavourable prognosis is because many systemic therapies fail to cross the blood brain barrier, and treatment options for brain metastasis are particularly limited23.…”

Section: Discussionsupporting

confidence: 85%

Impact of molecular subtypes on metastatic breast cancer patients: a SEER population-based study

Gong

Liu

et al. 2017

Sci Rep

172

173

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To investigate the significance and impact of molecular subtyping stratification on metastatic breast cancer patients, we identified 159,344 female breast cancer patients in the Surveillance, Epidemiology and End Results (SEER) database with known hormone receptor (HoR) and human epidermal growth factor receptor 2 (HER2) status. 4.8% of patients were identified as having stage IV disease, and were more likely to be HER2+/HoR−, HER2+/HoR+, or HER2−/HoR−. Stage IV breast cancer patients with a HER2+/HoR+ status exhibited the highest median overall survival (OS) (44.0 months) and those with a HER2−/HoR− status exhibited the lowest median OS (13.0 months). Patients with a HER2−/HoR+ status had more bone metastasis, whereas patients with a HER2+/HoR− status had an increased incidence of liver metastasis. Brain and lung metastasis were more likely to occur in women with a HER2−/HoR− status. The multivariable analysis revealed a significant interaction between single metastasis and molecular subtype. No matter which molecular subtype, women who did not undergo primary tumour surgery had worse survival than those who experienced primary tumour surgery. Collectively, our findings advanced the understanding that molecular subtype might lead to more tailored and effective therapies in metastatic breast cancer patients.

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“…Considering the differences in traditional concepts among people in different regions, the Chinese are pursuing active and comprehensive treatment, while the Western population is pursuing a higher quality of life, which may have led to the above-mentioned differences in treatment. Prior reports state that the median survival time of patients with MBC was 2-3 years (7,9,(15)(16)(17)(18). Andre et al (7) reported that the median survival time of patients with DnMBC was 23 months in 1987-1993, compared with 29 months in 1994-2000, of which most patients had single metastasis especially bone metastasis, >80% had received chemotherapy and 51% had received local surgery or radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

De�novo metastatic breast cancer: Subgroup analysis of molecular subtypes and prognosis

Zhang

et al. 2020

Oncol Lett

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The purpose of the present study was to analyze the clinical and pathological characteristics, treatment, and prognosis of de novo metastatic breast cancer (DnMBC). Information regarding 1,890 patients treated for advanced breast cancer at the Tianjin Medical University Cancer Hospital between January 2008 to December 2017 was collected. Clinicopathological characteristics, treatments and outcomes of these patients were compared using the chi-square test, log-rank test, and Cox regression analysis. A total of 171 patients were diagnosed with DnMBC. The median age at diagnosis was 53 years (range, 23-77). The percentage of T4 staging was higher (37.4%), 69.6% of patients were estrogen receptor (ER) positive, 59.1% were progesterone receptor positive, 29.8% had positive human epidermal growth factor receptor 2 (HER2) status, 68.4% had Ki-67 ≥20%, 55% had oligometastasis at the initial diagnosis, ~87.7% were treated with chemotherapy initially and 24% received palliative surgery for the primary tumor. After a median follow-up time of 26 months, the median progression-free survival (PFS) and overall survival (OS) among patients with DnMBC were 11 (8.7-13.3) months and 34 (27.9-40.1) months, respectively. In the multivariable model, ER status and sites of first metastasis (oligometastasis or polymetastasis) were identified to be independent predictors of PFS (P<0.05); ER status, primary tumor stage, and surgical treatment of primary tumors were identified to be independent predictors of OS (P<0.05). In conclusion, the clinicopathological characteristics of DnMBC are greater invasiveness and a higher risk of progression. Palliative surgical treatment may improve the prognosis of HR+/HER2-patients with oligometastasis. Therefore, individualized treatment as required is particularly important.

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Identifying the potential long-term survivors among breast cancer patients with distant metastasis

Cited by 34 publications

References 28 publications

Score for the Survival Probability in Metastasis Breast Cancer: A Nomogram-Based Risk Assessment Model

Score for the Survival Probability in Metastasis Breast Cancer: A Nomogram-Based Risk Assessment Model

Impact of molecular subtypes on metastatic breast cancer patients: a SEER population-based study

De�novo metastatic breast cancer: Subgroup analysis of molecular subtypes and prognosis

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