Erschienen in:
01.06.2017 | Clinical trial
Identifying long-term survivors among metastatic breast cancer patients undergoing primary tumor surgery
verfasst von:
Tae-Kyung Yoo, Byung Joo Chae, Sei Joong Kim, JungSun Lee, Tae In Yoon, Soo Jung Lee, Ho Yong Park, Heung Kyu Park, Yong Hwa Eom, Hyung Suk Kim, Chang Jong Kim, Man sik Shin, Sun Hyong You, Byung Joo Song
Erschienen in:
Breast Cancer Research and Treatment
|
Ausgabe 1/2017
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Abstract
Purpose
The prognostic role of primary tumor surgery in women with metastatic breast cancer at diagnosis is contentious. A subset of patients who will benefit from aggressive local treatment is needed to be identified. Using a nationwide database, we developed and validated a predictive model to identify long-term survivors among patients who had undergone primary tumor surgery.
Methods
A total of 150,043 patients were enrolled in the Korean Breast Cancer Registry between January 1990 and December 2014. Of these, 2332 (1.6%) presented with distant metastasis at diagnosis. Using Cox proportional hazards regression, we developed and validated a model that predicts survival in patients who undergo primary tumor surgery, based on the clinicopathological features of the primary tumor.
Results
A total of 2232 metastatic breast cancer patients were reviewed. Of these, 1541 (69.0%) patients had undergone primary tumor surgery. The 3-year survival rate was 62.6% in this subgroup. Among these patients, advanced T-stage, high-grade tumor, lymphovascular invasion, negative estrogen receptor status, high Ki-67 expression, and abnormal CA 15-3 and alkaline phosphatase levels were associated with poor survival. A prediction model was developed based on these factors, which successfully identified patients with remarkable survival (score 0–3, 3-year survival rate 87.3%). The clinical significance of the model was also validated with an independent dataset.
Conclusions
We have developed a predictive model to identify long-term survivors among women who undergo primary tumor surgery. This model will provide guidance to patients and physicians when considering surgery as a treatment modality for metastatic breast cancer.