Prognostic factors affecting the outcome of brain metastases from breast cancer

Liu, Mu-Tai; Hsieh, Chang‐Yao; Wang, Ai-Yih; Chang, Tse Wen; Pi, Chu-Pin; Huang, Chia-Chun; Huang, Chao-Yuan; Liou, Cheng-Hong

doi:10.1007/s00520-006-0164-0

Cited by 8 publications

(3 citation statements)

References 3 publications

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“…The authors observed median survival rates of 7.1, 4.2, and 2.3 months for patients who were categorized as recursive partitioning analysis class I, II, and III, respectively. Since its development, this prognostic system has been widely validated 10,21,22. In our study, women categorized as recursive partitioning analysis class I/II and III had median survival rates of 11 and 2 months, respectively ( P < .0001).…”

Section: Discussionmentioning

confidence: 73%

“…However, the prognoses of women with breast cancer and treated brain metastases vary. Several studies have reported factors that can predict for better prognosis, including younger age at brain metastases diagnosis, fewer lesions, and higher Karnofsky performance score (KPS) 9,10. In addition, stratification by Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis, a classification that is based on age, KPS, and disease status, has consistently been shown to predict for prognosis, with best survival rates observed in recursive partitioning analysis class I patients and worst among recursive partitioning analysis class III patients 11…”

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confidence: 99%

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Prognostic factors of survival in the trastuzumab era among women with breast cancer and brain metastases who receive whole brain radiotherapy

Dawood

González-Angulo

Albarracin

et al. 2010

Cancer

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BACKGROUND:The objective of this study was to review the outcome of women with breast cancer with known receptor status who were treated with whole brain radiotherapy for brain metastases and to determine factors that impact survival. METHODS: A total of 223 women with breast cancer and brain metastases, who received whole brain radiotherapy, were identified. All women with HER-2-positive disease had received trastuzumab. Kaplan-Meier product limit method was used to determine overall survival (OS) estimates. Cox proportional hazards models were then fitted to explore the association of OS with various patient and tumor characteristics. RESULTS: Median age at brain metastases diagnosis was 50 years. Sixty-seven (30.2%) patients had hormone receptor-positive/HER-2-negative disease, 101 (45.50%) had HER-2-positive disease, and 54 (24.3%) had triple receptor-negative disease. Median OS from brain metastases was 6 months, with 1-year survival of 30% (95% confidence interval [CI], 23%-36%). Women with hormone receptor-positive/HER-2-negative, HER-2-positive, and triple-negative tumors had median survivals of 5, 9, and 5 months, respectively (P ¼.0069). In the multivariate model, women with HER-2-positive disease had a significantly decreased risk of death compared with women with hormone receptor-positive/HER-2-negative disease (hazard ratio, 0.63; 95%CI, 0.42-0.94; P ¼.02). The risk of death among women with triple-negative disease compared with hormone receptor-positive/HER-2-negative disease was not significantly different (P ¼.54). Lower recursive partitioning analysis class and 30-gray brain radiation dose were also significantly associated with a decreased risk of death. CONCLUSIONS: Breast tumor subtype has a significant prognostic role among women with breast cancer and brain metastases. In addition, in the trastuzumab era factors such as recursive partitioning analysis and adequate radiation dose continue to be important prognostic factors. Cancer 2010;116:3084-92.

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Section: Discussionmentioning

confidence: 73%

mentioning

confidence: 99%

Prognostic factors of survival in the trastuzumab era among women with breast cancer and brain metastases who receive whole brain radiotherapy

Dawood

González-Angulo

Albarracin

et al. 2010

Cancer

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“…Le caractère unique a un impact pronostique favorable (162,288). La médiane de survie est d'environ 15 mois.…”

Section: Métastase Cérébrale Uniqueunclassified

Cancer du sein en situation métastatique

Namer¹,

Héry²,

Spielmann³

et al. 2010

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Cet ouvrage est soumis au copyright. Tous droits réservés, notamment la reproduction et la représentation, la traduction, la réimpression, l'exposé, la reproduction des illustrations et des tableaux, la transmission par voie d'enregistrement sonore ou visuel, la reproduction par microfilm ou tout autre moyen ainsi que la conservation des banques de données. La loi française sur le copyright du 9 septembre 1965 dans la version en vigueur n'autorise une reproduction intégrale ou partielle que dans certains cas, et en principe moyennant le paiement des droits. Toute représentation, reproduction, contrefaçon ou conservation dans une banque de données par quelque procédé que ce soit est sanctionnée par la loi pénale sur le copyright.L'utilisation dans cet ouvrage de désignations, dénominations commerciales, marques de fabrique, etc. même sans spécification ne signifie pas que ces termes soient libres de la législation sur les marques de fabrique et la protection des marques et qu'ils puissent être utilisés par chacun.La maison d'édition décline toute responsabilité quant à l'exactitude des indications de dosage et des modes d'emplois. Dans chaque cas il incombe à l'usager de vérifier les informations données par comparaison à la littérature existante.

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Hormone receptor status as a prognostic factor affecting the outcome of brain metastases

Harputluoğlu

Pürnak

Altundağ

2006

Support Care Cancer

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Hormone receptor status as a prognostic factor affecting the outcome of brain metastases To The Editor, We congratulate Liu et al. [1] for their retrospective study in which they tried to determine prognostic factors affecting outcomes of brain metastases from breast cancer. They found that Karnofsky performance status and the number of brain metastases were statistically significant for overall survival in multivariate analysis. However, they did not include hormone receptor status in predicting survival rate. Recent retrospective study evaluated clinical data from 420 patients who had been diagnosed with breast cancer and brain metastasis between 1994 and 2004 at M. D. Anderson Cancer Center. In this study, median follow-up after brain metastasis was 6 months (range 0.7 to 95.9 months), and the overall median survival was 6.8 months [2]. In univariate analysis, younger patients, positive hormone receptor status, single metastatic lesion of brain, and brain metastases as a site of the first metastasis had significantly better survival. However, only the age at the time of diagnosis and estrogen receptor (ER) were significantly associated with overall survival in the multivariate analysis. Patients with ER-positive disease tended to have longer overall survival compared to patients with ER-negative disease (p=0.003). Patients 50 years of age or less tended to have longer overall survival compared to patients more than 50 years of age (p=0.047). HER2 was not included in this analysis because of the large amount of missing data associated with this characteristic. In conclusion, although the survival of patients with breast cancer metastatic to brain is generally poor, there are some long-term survivors such as younger patients with hormone receptor positive histology, good performance status, and single metastatic lesion. More aggressive treatment approach may be considered for these patients. Detailed molecular characterization of brain metastases from breast cancer might lead to more in-depth understanding of those biological abnormalities. References1. Liu MT, Hsieh CY, Wang AY, Chang TH, Pi CP, Huang CC, Huang CY, Liou CH (2006) Prognostic factors affecting the outcome of brain metastases from breast cancer. Support Care Cancer 14:936-942 2. Altundag K, Bondy ML, Kau SW, Broglio K, Rivera E (2005) Clinicopathologic characteristics and prognostic factors in 420 metastatic breast cancer patients with central nervous system metastases. Breast Cancer Res Treat 94 (Suppl 1):S143(Abstract 3056)

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Prognostic factors affecting the outcome of brain metastases from breast cancer

Cited by 8 publications

References 3 publications

Prognostic factors of survival in the trastuzumab era among women with breast cancer and brain metastases who receive whole brain radiotherapy

Prognostic factors of survival in the trastuzumab era among women with breast cancer and brain metastases who receive whole brain radiotherapy

Cancer du sein en situation métastatique

Hormone receptor status as a prognostic factor affecting the outcome of brain metastases

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