scholarly journals Surgical Efficacy and Prognosis of 54 Cases of Spinal Metastases from Breast Cancer

2021 ◽  
Author(s):  
Yao weitao ◽  
Li Zhehuang ◽  
Zhang Boya ◽  
Du Xinhui ◽  
Wang Jiaqiang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Survival Rate ◽  
Brain Metastasis ◽  
Survival Time ◽  
Poor Prognosis ◽  
Spinal Metastasis ◽  
Spinal Metastases ◽  
Predictive Ability ◽  
Postoperative Survival

Abstract OBJECTIVE To analyze the efficacy and complications of spinal metastasis surgery for breast cancer; to understand the survival and the influencing factors; and to verify the predictive ability of the currently used spinal metastasis cancer survival prediction scoring system on the 1-year postoperative survival rate. METHODS A retrospective study was conducted on 54 patients with spinal metastases from breast cancer who underwent open surgery after multidisciplinary consultation in our hospital from January 2017 to October 2020. Patient demographic-related variables, breast cancer-related variables, spinal disorders-related variables, and treatment-related variables were collected. Survival curves were plotted using the Kaplan-Meier method, one-way tests were performed using the Log-rank method for factors that might affect prognosis, and candidate variables were included in the Cox model for multifactor analysis. The Tomita score, modified Tokuhashi score, modified Bauer score, modified Katagiri score were examined by plotting the subject operating characteristic curve (ROC) and calculating the area under curve (AUC) The AUC was used to test the predictive ability of the SORG (Skeletal Oncology Research Group) original version, SORG line graph version, and SORG web version for 1-year postoperative survival in patients with spinal metastases from breast cancer. RESULTS The average age was 51.3±8.6 years in 54 patients. Twenty-one patients underwent vertebral body debulking surgery, 32 patients underwent palliative canal decompression, and 1 patient underwent vertebral en bloc resection, with an operative time of 229.3 ± 87.6 minutes and intraoperative bleeding of 1018.1 ± 931.1 ml. Postoperatively, the patient experienced significant pain relief and gradual recovery from nerve injury. Major surgical complications included cerebrospinal fluid leakage, secondary spinal cord injury, spinal tumor progression, and broken of fixation. The mean survival time was 32.2 months, including a 6-month survival rate of 90.7%, a 1-year survival rate of 77.8%, and a 2-year survival rate of 60.3%. Univariate analysis showed that pre-operation with neurological deficits, hormone-insensitive type, with brain metastases were potential risk factors for poor prognosis. Multifactorial analysis showed that hormone-insensitive type and concomitant brain metastasis were independent risk factors associated with poor prognosis. The SORG web version had good ability to predict 1-year postoperative survival in patients with spinal metastases from breast cancer. Conclusion Spinal metastasis from breast cancer has good surgical efficacy, low postoperative recurrence rate, and relatively long survival time after surgery. Patients with hormone-insensitive type, with brain metastasis have poor prognosis, and SORG web version can predict patients' 1-year survival more accurately.

scholarly journals Survival of Spinal Metastasis Disease based on Immunohistochemistry Subtype of Breast Cancer: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (F) ◽  
pp. 101-105
Author(s):  
Ivan Hugo Hadisaputra ◽  
Tjokorda Gde Bagus Mahadewa ◽  
Putu Eka Mardhika
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Survival Time ◽  
Spinal Metastasis ◽  
Meta Analysis ◽  
Spinal Metastases ◽  
Luminal A ◽  
Luminal B ◽  
Moderate Growth ◽  
Her 2

BACKGROUND: Breast cancer is categorized as a slow-growth tumor in the spinal metastases disease (SMD) scoring system. Based on immunohistochemistry, breast cancer has four subtypes: Luminal A (LumA), luminal B (LumB), human epidermal growth factor 2 (Her-2) type, and triple-negative breast cancer (TNBC). TNBC has the poorest prognosis. AIM: This study aimed to describe the survival time of breast cancer with SMD based on immunohistochemistry subtypes through systematic review and meta-analysis. METHODS: This is a systematic review and meta-analysis study. This study used electronic articles published in PubMed and CENTRAL online database. We used keywords ([breast] AND [cancer] AND [spine] AND [metastasis]) to find eligible studies. Articles included were full-text studies in English. Survival time as the outcome was pooled according to the immunohistochemistry subtype of breast cancer. Statistical analysis was performed using software Stata. RESULTS: Five articles met our inclusion and exclusion criteria. LumA, LumB, Her-2 type, and TNBC have a survival time of 32.84 months, 35.20 months, 60.8 months, and 14.27 months, respectively. CONCLUSION: TNBC has the lowest survival time in the pooled analysis. We proposed TNBC be categorized as a moderate growth primary tumor.

scholarly journals FGFR aberrations increase the risk of brain metastases and predict poor prognosis in metastatic breast cancer patients

2020 ◽  
Vol 12 ◽  
pp. 175883592091530
Author(s):  
Ning Xie ◽  
Can Tian ◽  
Hui Wu ◽  
Xiaohong Yang ◽  
Liping liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Brain Metastasis ◽  
Poor Prognosis ◽  
Significant Risk ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Genetic Aberrations ◽  
Increased Risk

Background: The survival status of patients with breast cancer and brain metastasis (BCBM) receiving current treatments is poor. Method: We designed a real-world study to investigate using patients’ clinical and genetic aberrations to forecast the prognoses of BCBM patients. We recruited 146 BCBM patients and analyzed their clinical features to evaluate the overall survival (OS). For genetic testing, 30 BCBM and 165 non-brain-metastatic (BM) metastatic breast cancer (MBC) patients from Hunan Cancer Hospital, and 86 BCBM and 1416 non-BM MBC patients from the Geneplus database who received circulating tumor DNA testing, were compared and analyzed. Results: Ki67 >14% and >3 metastatic brain tumors were significant risk factors associated with poor OS, while chemotherapy and brain radiotherapy were beneficial factors for better OS. Compared with non-BM MBC patients, BCBM patients had more fibroblast growth factor receptor ( FGFR) aberrations. The combination of FGFR, TP53 and FLT1 aberrations plus immunohistochemistry HER2-positive were associated with an increased risk of brain metastasis (AUC = 77.13%). FGFR aberration alone was not only a predictive factor (AUC = 67.90%), but also a significant risk factor for poor progression-free survival (Logrank p = 0.029). FGFR1 aberration was more frequent than other FGFR family genes in BCBM patients, and FGFR1 aberration was significantly higher in BCBM patients than non-BM MBC patients. Most FGFR1-amplified MBC patients progressed within 3 months of the late-line (>2 lines) treatment. Conclusion: A group of genetic events, including FGFR, TP53 and FLT1 genetic aberrations, and HER2-positivity, forecasted the occurrence of BM in breast cancers. FGFR genetic aberration alone predicted poor prognosis.

Survival rates in patients with primary metastatic breast cancer over a 10-year period: A retrospective analysis based on individual patient data from a multicenter data bank.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1577-1577
Author(s):  
Jana Barinoff ◽  
Philipp Harter ◽  
Florian Heitz ◽  
Christine Dittmer ◽  
Sherko Kuemmel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Metastatic Breast Cancer ◽  
Survival Rate ◽  
Survival Time ◽  
Median Survival Time ◽  
Survival Rates ◽  
Metastatic Breast ◽  
Data Bank ◽  
Therapy Options

1577 Background: Approximately 6% of patients with breast cancer have distant metastases at the time of the initial diagnosis. The aim of this analysis was to examine the overall survival rate over time and to investigate the effect of new therapy options. Methods: This retrospective analysis was performed based on the data bank of the Clinic for Gynaecological Oncology/ Dr. Horst Schmidt Klinik, Wiesbaden and the Clinic for Gynaecological Oncology and Senology/ Kliniken Essen Mitte, Essen. The patients with primary metastatic breast cancer (pmBC) who were diagnosed and treated at the accredited breast cancer centres of these clinics were enrolled between 1998 and 2007. The date of diagnosis was used to define 2 specifically chosen 5-year periods: 1998–2002 and 2003–2007. The follow-up time was on average 76 months. The Breslow Test was used to evaluate changes in the median survival time and to detect factors associated with the increase in survival rates. Results: Two hundred sixteen patients with complete baselines were analysed. Ninety patients were diagnosed between 1998 and 2002, and 126 patients received their diagnosis of pmBC between 2003 and 2007. The tumour-biological factors were the same in both groups, whereas the therapeutic concepts were different—the later group (2003–2007) received more aromatase inhibitors, taxane-based chemotherapy and trastuzumab. This finding resulted in an increased median survival time from 31 months in the years 1998–2002 to 44 months in the group with the first diagnosis between 2003 and 2007. Conclusions: Primary metastatic breast cancer occurred at constant rates over last 10 years. The tumour findings did not change in the time between the two examined groups; however, the treatment options in the 2003–2007 group included newly approved therapies. The time period of the first diagnosis was detected as a risk factor for overall survival. Those patients diagnosed in the more recent time frame had a significantly improved survival rate. The establishment of new therapy options may explain this finding.

5106 Predictive risk factors for brain metastasis in breast cancer

2009 ◽  
Vol 7 (2) ◽  
pp. 292
Author(s):  
A. Sezer ◽  
T. Sümbül ◽  
F. Köse ◽  
C. Karadeniz ◽  
H. Mertsoylu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Brain Metastasis ◽  
Predictive Risk

scholarly journals Survival Analysis: A Hospital Based Retrospective Life Span Study of Breast Cancer Patients after First Recurrence

2020 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
Madiha Liaqat ◽  
◽  
Waqas Fazil ◽  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Life Span ◽  
Survival Time ◽  
Cancer Patients ◽  
Cox Regression ◽  
Molecular Subtype ◽  
Published Data ◽  
Lower Grade ◽  
Breast Cancer Patients

Background Overall survival of breast cancer patients has been calculated many times but there is no precise research available regarding the survival time of breast cancer patients after recurrence. We investigated the effects factors on mortality due to breast cancer. Methods All Factors were analyzed using statistical tools and techniques to find out rate of mortality after recurrence. Descriptive statistics, cox proportional hazard models were used to find statistical significant variables. In the present study recurrence is considered as an important event which may play a role in study of breast cancer progression. In this study, we evaluated breast cancer risk factors in relation to mortality due to this disease among 1028 women with breast cancer in Lahore, Pakistan. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between risk factors and mortality due to breast cancer were estimated in subtype-specific Cox regression models. Results Survival of breast cancer patients depends upon many factors. A total of 581 alive and 447 deaths due to breast cancer occurred during a median follow-up period of 1977 days. Median survival time after recurrence was 3 years. Significant factors were included post- menopausal women who diagnosed and had recurrence at the age < 45 of molecular subtype estrogen receptor positive, progesterone receptor negative, Her2.neu positive with tumor size ≥ 3 & involved lymph nodes >5. Radiotherapy has increased life span of patients even after recurrence. Conclusion Younger women had higher risk of mortality after recurrence even gone through chemotherapy while lower grade tumor had good prognosis. Radiotherapy played a major role in increasing life time of breast cancer women after recurrence. Our findings are consistent with those from previously published data.

Total Brain Irradiation for Metastatic Lesions in Breast Cancer Patients

2021 ◽  
Vol 66 (6) ◽  
pp. 71-74
Author(s):  
A. Balkanov ◽  
V. Metelin ◽  
I. Vasilenko
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Brain Metastasis ◽  
Cancer Patients ◽  
Time Interval ◽  
Breast Cancer Patients ◽  
Brain Irradiation ◽  
Risk Of Death ◽  
Total Brain ◽  
Breast Cancer Brain Metastasis

Purpose: Brain metastasis (BM) has a significant negative impact on the survival of breast cancer patients. An intensive search is underway for a multi-modal approach to identify the most effective methods of treating such patients. Material and methods: The study included 40 patients with breast cancer who were diagnosed with BM on magnetic resonance imaging (MRI) of the brain. Total brain irradiation (TBI) up to 30 Gy (3 Gy) was used as the main treatment method. The median age was 48 (31–70) years. In 75 % of cases, a nonluminal subtype of breast cancer was found, in 57.5 % of cases–T2 breast cancer, in 70 % of cases–N0-1. Results: The median survival after TBI was 12 months, 6-month survival rate was 70 %, and 12 – month survival rate was 47.5 %. The risk of death was significantly increased (HR=3.309; 95 % CI: 1,184 – 9,250, p=0.023) in patients whose time interval from the manifestation of 1 relapse to BM was ≤24 months. In these patients, the survival was only 9.5 months and was significantly lower (p=0.0136) than in the patients with the same time interval was >24 months – 30 months. Conclusions: It was found that the effectiveness of total brain irradiation in patients with breast cancer brain metastasis is the highest if the time interval from the moment of manifestation of first relapse to brain metastasis is more than 24 months.

scholarly journals Cystic brain metastasis is associated with poor prognosis in patients with advanced breast cancer

Oncotarget ◽  
2016 ◽  
Vol 7 (45) ◽  
pp. 74006-74014 ◽  
Author(s):  
Bing Sun ◽  
Zhou Huang ◽  
Shikai Wu ◽  
Lijuan Ding ◽  
Ge Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Advanced Breast Cancer ◽  
Poor Prognosis ◽  
Advanced Breast

scholarly journals Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis

2017 ◽  
Vol 27 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Brad E. Zacharia ◽  
Sweena Kahn ◽  
Evan D. Bander ◽  
Gustav Y. Cederquist ◽  
William P. Cope ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Spinal Metastasis ◽  
Univariate Analysis ◽  
Previous History ◽  
Vena Cava ◽  
Spinal Metastases ◽  
Multivariate Logistic Regression Model ◽  
Histopathological Classification

OBJECTIVEThe authors of this study aimed to identify the incidence of and risk factors for preoperative deep venous thrombosis (DVT) in patients undergoing surgical treatment for spinal metastases.METHODSUnivariate analysis of patient age, sex, ethnicity, laboratory values, comorbidities, preoperative ambulatory status, histopathological classification, spinal level, and surgical details was performed. Factors significantly associated with DVT univariately were entered into a multivariate logistic regression model.RESULTSThe authors identified 314 patients, of whom 232 (73.9%) were screened preoperatively for a DVT. Of those screened, 22 (9.48%) were diagnosed with a DVT. The screened patients were older (median 62 vs 55 years, p = 0.0008), but otherwise similar in baseline characteristics. Nonambulatory status, previous history of DVT, lower partial thromboplastin time, and lower hemoglobin level were statistically significant and independent factors associated with positive results of screening for a DVT. Results of screening were positive in only 6.4% of ambulatory patients in contrast to 24.4% of nonambulatory patients, yielding an odds ratio of 4.73 (95% CI 1.88–11.90). All of the patients who had positive screening results underwent preoperative placement of an inferior vena cava filter.CONCLUSIONSPatients requiring surgery for spinal metastases represent a population with unique risks for venous thromboembolism. This study showed a 9.48% incidence of DVT in patients screened preoperatively. The highest rates of preoperative DVT were identified in nonambulatory patients, who were found to have a 4-fold increase in the likelihood of harboring a DVT. Understanding the preoperative thrombotic status may provide an opportunity for early intervention and risk stratification in this critically ill population.

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