Clinicopathological features and prognostic analysis of initially diagnosed stage Ⅳ breast cancer bone metastasis
10.3969/j.issn.1000-8179.2019.18.595
- VernacularTitle:首诊Ⅳ期乳腺癌骨转移患者的临床病理特征及预后分析
- Author:
Jianna SUN
1
,
2
;
Hong LIU
;
Lingjun KONG
;
Xiaodong YUAN
Author Information
1. 河北省沧州中西医结合医院乳腺外科
2. 天津医科大学肿瘤医院乳腺肿瘤二科
- Keywords:
initially diagnosed stage Ⅳ breast cancer bone metastasis (IDBCBM);
clinicopathological characteristics;
treatment;
prognosis
- From:
Chinese Journal of Clinical Oncology
2019;46(18):940-944
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To examine the relationship of clinicopathological features and treatment strategies with the prognosis of patients with initially diagnosed stageⅣbreast cancer bone metastasis (IDBCBM). Methods: Clinical data from 74 patients with IDBCBM who were treated at Tianjin Medical University Cancer Institute and Hospital between March 2007 and November 2016 were analyzed retrospectively. A univariate analysis of prognosis was conducted using a Log-rank test, and the subsequent multivariate analysis was conducted using a Cox regression model. Results: The median age of the patients was 53.3 years. The median total survival duration (overall survival, OS) was 34.3 months, and the 3-and 5-year survival rates were 37.8% and 12.2%, respectively. Patients for whom the first distant metastasis was bone metastasis only had a better prognosis, with a median survival duration of 41.7 months and overall 3-and 5-year survival rates of 54.5% and 20.4%, respectively. In the univariate analysis, molecular subtype, hormonal receptor status, HER-2 expression levels, nodal status, Ki-67 index, number of bone metastases (NBM), initial mode of metastasis, mode of therapy, and locoregional treatment showed an association with prognosis. Further, multivariate analysis demonstrated that Ki-67 index, NBM, mode of therapy, and initial mode of metastasis were independent factors affecting OS (P<0.05). Conclusions: A high Ki-67 index, single mode therapy, the presence of multiple bone metastases, and accompanying visceral metastasis were associated with a poor prognosis. However, it remains unclear whether locoregional treatment, including surgery and radiotherapy treatment of the primary tumor, is beneficial.
