Limited M1 Disease: A Significant Prognostic Factor for Stage IV Breast Cancer

Abstract Introduction : Tumour subtype have a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of bone metastases at diagnosis of breast cancer are lacking.The aim of this study was to analyse the influence of tumour subtype and other factors in the prognostic and survival of patients with bone metastases of stage IV breast cancer. Methods : Using the Surveillance, Epidemiology, and End Results Program (SEER) data of 2012 to 2016 conducted a retrospective cohort study to investigate stage IV patients with bone metastases in breast cancer. Stage IV Patients characteristic according subtype were compared using chi-square, overall survival (OS), prognostic factor calculated using the Kaplan-Meier method and the Cox proportional hazards model. Results : A total of 3384 stage IV patients were included in this study. 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. Median OS for the whole population was 38 months, 33.9% of the patients were alive at five-year. The median OS and five-year survival rate among the different subtype of breast cancer stage IV patients are significant differences ( p <0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270 ), black race (HR=1.317 ), grade in III/IV ( HR=1.960 ), HR-/HER2- (HR=2.808 ), lung metastases (HR=1.378 ), live metastases ( HR= 2.085 ), brain metastases (HR=1.903 ) are independent risk factors of prognosis; married ( HR=0.819 ), HR+/HER2+ (HR= 0.631 ), HR-/HER2+ (HR= 0.716 ), insurance ( HR=0.587 ) and surgery (HR=0.504 ) are independent protection factors of prognosis. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases , HR=0.694 , 95%CI: 0.485 -0.992 on prognosis. Conclusions : There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases ）on prognosis. Tumour subtype, as a significant prognostic factor, warrant further investigation.

Download Full-text

Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER-based study

10.21203/rs.2.16521/v5 ◽

2020 ◽

Author(s):

Xiao Li ◽

Xiaoli Zhang ◽

Shen Yin Zhong ◽

Jie Liu

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Cancer Patients ◽

Cox Regression ◽

Stage Iv ◽

Cox Proportional Hazards Model ◽

Significant Prognostic Factor ◽

Breast Cancer Patients ◽

Cox Regression Analysis ◽

Stage Iv Breast Cancer

Abstract Background: Tumour subtype has a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of patients with bone metastases at breast cancer diagnosis are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors on the prognosis and survival of patients with bone metastases of breast cancer.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) Program data from 2012 to 2016, a retrospective cohort study was conducted to investigate stage IV breast cancer patients with bone metastases. Stage IV patient characteristics according to subtype were compared using chi-square tests. Overall survival (OS) and prognostic factors were compared using the Kaplan-Meier method and the Cox proportional hazards model, respectively.Results: A total of 3384 stage IV patients were included in this study; 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. The median OS for the whole population was 38 months, and 33.9% of the patients were alive at five years. The median OS and five-year survival rate were significantly different among stage IV breast cancer patients with different molecular subtypes (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270), black race (HR=1.317), grade III or IV (HR=1.960), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), liver metastases (HR=2.085), and brain metastases (HR=1.903) were independent risk factors for prognosis; married status (HR=0.819), HR+/HER2+ (HR=0.631), HR-/HER2+ (HR=0.716), insurance (HR=0.587) and surgery (HR=0.504) were independent protection factors of prognosis. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95% CI: 0.485-0.992), but the interaction between race and subtype did not reach significance for prognosis.Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS were age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases) for prognosis. Tumour subtype, as a significant prognostic factor, warrants further investigation.

Download Full-text

Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER based study

10.21203/rs.2.16521/v3 ◽

2020 ◽

Author(s):

Xiao Li ◽

Xiaoli Zhang ◽

Jie Liu

Keyword(s):

Breast Cancer ◽

Prognostic Factor ◽

Bone Metastases ◽

Cox Regression ◽

Molecular Subtype ◽

Stage Iv ◽

Cox Proportional Hazards Model ◽

Significant Prognostic Factor ◽

Cancer Stage ◽

Cox Regression Analysis

Abstract Background : Tumour subtype have a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of bone metastases at diagnosis of breast cancer are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors in the prognostic and survival of patients with bone metastases of breast cancer. Methods : Using the Surveillance, Epidemiology, and End Results Program (SEER) data of 2012 to 2016 conducted a retrospective cohort study to investigate stage IV patients with bone metastases in breast cancer. Stage IV Patients characteristic according subtype were compared using chi-square, overall survival (OS), prognostic factor calculated using the Kaplan-Meier method and the Cox proportional hazards model. Results : A total of 3384 stage IV patients were included in this study. 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. Median OS for the whole population was 38 months, and 33.9% of the patients were alive at five-year. The median OS and five-year survival rate among the different molecular subtype of breast cancer stage IV patients are significant differences ( p <0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270 ), black race ( HR=1.317 ), grade in III or IV ( HR=1.960 ), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), live metastases (HR=2.085), brain metastases (HR=1.903) are independent risk factors of prognosis; married (HR=0.819 ), HR+/HER2+ (HR=0.631 ), HR-/HER2+ (HR=0.716), insurance (HR=0.587 ) and surgery (HR=0.504) are independent protection factors of prognosis. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95%CI: 0.485-0.992）,but interaction between race and substype did not reach significance on prognosis. Conclusions : There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases) on prognosis. Tumour subtype, as a significant prognostic factor, warrant further investigation. Keywords : Breast cancer, Bone metastases, Tumour subtype, Prognosis factor, Survival

Download Full-text

Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER based study

10.21203/rs.2.16521/v4 ◽

2020 ◽

Author(s):

Xiao Li ◽

Xiaoli Zhang ◽

Jie Liu

Keyword(s):

Breast Cancer ◽

Prognostic Factor ◽

Bone Metastases ◽

Cox Regression ◽

Molecular Subtype ◽

Stage Iv ◽

Cox Proportional Hazards Model ◽

Significant Prognostic Factor ◽

Cancer Stage ◽

Cox Regression Analysis

Abstract Background: Tumour subtype have a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of bone metastases at diagnosis of breast cancer are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors in the prognostic and survival of patients with bone metastases of breast cancer.Methods: Using the Surveillance, Epidemiology, and End Results Program (SEER) data of 2012 to 2016 conducted a retrospective cohort study to investigate stage IV patients with bone metastases in breast cancer. Stage IV Patients characteristic according subtype were compared using chi-square. Overall survival (OS), prognostic factor calculated using the Kaplan-Meier method and the Cox proportional hazards model.Results: A total of 3384 stage IV patients were included in this study. 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. Median OS for the whole population was 38 months, and 33.9% of the patients were alive at five-year. The median OS and five-year survival rate among the different molecular subtype of breast cancer stage IV patients are significant differences (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270), black race (HR=1.317), grade in III or IV (HR=1.960), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), live metastases (HR=2.085), brain metastases (HR=1.903) are independent risk factors of prognosis; married (HR=0.819), HR+/HER2+ (HR=0.631), HR-/HER2+ (HR=0.716), insurance (HR=0.587) and surgery (HR=0.504) are independent protection factors of prognosis. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95%CI: 0.485-0.992), but interaction between race and substype did not reach significance on prognosis. Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases) on prognosis. Tumour subtype, as a significant prognostic factor, warrant further investigation.

Download Full-text

Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER-based study

BMC Cancer ◽

10.1186/s12885-020-07593-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Xiao Li ◽

Xiaoli Zhang ◽

Jie Liu ◽

Yinzhong Shen

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Bone Metastases ◽

Cancer Patients ◽

Cox Regression ◽

Stage Iv ◽

Significant Prognostic Factor ◽

Breast Cancer Patients ◽

Cox Regression Analysis ◽

Stage Iv Breast Cancer

Abstract Background Tumour subtype has a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of patients with bone metastases at breast cancer diagnosis are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors on the prognosis and survival of patients with bone metastases of breast cancer. Methods Using the Surveillance, Epidemiology, and End Results (SEER) Program data from 2012 to 2016, a retrospective cohort study was conducted to investigate stage IV breast cancer patients with bone metastases. Stage IV patient characteristics according to subtype were compared using chi-square tests. Overall survival (OS) and prognostic factors were compared using the Kaplan-Meier method and the Cox proportional hazards model, respectively. Results A total of 3384 stage IV patients were included in this study; 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR−/HER2-, and 7.39% were HR−/HER2+. The median OS for the whole population was 38 months, and 33.9% of the patients were alive at 5 years. The median OS and five-year survival rate were significantly different among stage IV breast cancer patients with different molecular subtypes (p < 0.05). Multivariate Cox regression analysis showed that age of 55–59 (HR = 1.270), black race (HR = 1.317), grade III or IV (HR = 1.960), HR−/HER2- (HR = 2.808), lung metastases (HR = 1.378), liver metastases (HR = 2.085), and brain metastases (HR = 1.903) were independent risk factors for prognosis; married status (HR = 0.819), HR+/HER2+ (HR = 0.631), HR−/HER2+ (HR = 0.716), insurance (HR = 0.587) and surgery (HR = 0.504) were independent protection factors of prognosis. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases, HR = 0.694, 95% CI: 0.485–0.992), but the interaction between race and subtype did not reach significance for prognosis. Conclusions There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS were age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases) for prognosis. Tumour subtype, as a significant prognostic factor, warrants further investigation.

Download Full-text

Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER-based study

10.21203/rs.2.16521/v6 ◽

2020 ◽

Author(s):

Xiao Li ◽

XiaoLi Zhang ◽

Jie Liu ◽

Shen Yin Zhong

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Bone Metastases ◽

Cancer Patients ◽

Cox Regression ◽

Stage Iv ◽

Significant Prognostic Factor ◽

Breast Cancer Patients ◽

Cox Regression Analysis ◽

Stage Iv Breast Cancer

Abstract Background: Tumour subtype has a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of patients with bone metastases at breast cancer diagnosis are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors on the prognosis and survival of patients with bone metastases of breast cancer.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) Program data from 2012 to 2016, a retrospective cohort study was conducted to investigate stage IV breast cancer patients with bone metastases. Stage IV patient characteristics according to subtype were compared using chi-square tests. Overall survival (OS) and prognostic factors were compared using the Kaplan-Meier method and the Cox proportional hazards model, respectively.Results: A total of 3384 stage IV patients were included in this study; 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. The median OS for the whole population was 38 months, and 33.9% of the patients were alive at five years. The median OS and five-year survival rate were significantly different among stage IV breast cancer patients with different molecular subtypes (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270), black race (HR=1.317), grade III or IV (HR=1.960), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), liver metastases (HR=2.085), and brain metastases (HR=1.903) were independent risk factors for prognosis; married status (HR=0.819), HR+/HER2+ (HR=0.631), HR-/HER2+ (HR=0.716), insurance (HR=0.587) and surgery (HR=0.504) were independent protection factors of prognosis. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95% CI: 0.485-0.992), but the interaction between race and subtype did not reach significance for prognosis.Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS were age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There was an interaction between the HR+/HER2+ subtype and other metastases (except bone metastases) for prognosis. Tumour subtype, as a significant prognostic factor, warrants further investigation.

Download Full-text