Trends in Survival Over the Past Two Decades Among White and Black Patients With Newly Diagnosed Stage IV Breast Cancer
Trends in Survival Over the Past Two Decades Among White and Black Patients With Newly Diagnosed Stage IV Breast Cancer
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DOI：
10.1200/jco.2007.14.1168
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发表时间：
2008-10-20
影响因子：
45.3
通讯作者：
Giordano, Sharon H.
中科院分区：
文献类型：
--
作者：
Dawood, Shaheenah;Broglio, Kristine;Giordano, Sharon H.
总体而言，乳腺癌死亡率在美国一直在下降，但对IV期乳腺癌患者的生存研究有限。本研究的目的是评估的趋势和因素影响生存在一个大的人群为基础的队列患者新诊断的第四阶段breastcancer.Patients和MethodsWe搜索的监测，流行病学和最终结果注册，以确定女性患者的第四阶段乳腺癌诊断1988年和2003年之间。根据诊断年份（1988年至1993年，1994年至1998年和1999年至2003年）将患者分为三组。Kaplan-Meier法估计生存结局，并拟合考克斯模型，以确定独立与survival.ResultsWe确定了15,438例患者的特征。中位年龄为62岁。1988 - 1993年、1994 - 1998年和1999 - 2003年的中位随访时间分别为16个月、18个月和11个月。乳腺癌特异性生存期中位数为23个月。在多变量模型中，早期诊断、3级疾病、年龄增加、未婚、激素受体阴性疾病和未手术均与总体和乳腺癌特异性生存率较差独立相关。随着每一个连续一年的诊断，黑人患者的死亡风险越来越大相比，白色患者（危害比，1.03; 95%CI，1.00至1.06; P = 0.031）。结论新诊断的第四期乳腺癌患者的生存率随着时间的推移略有改善，但这些数据表明，黑人和白色患者之间的生存差距有所增加。
PurposeOverall, breast cancer mortality has been declining in the United States, but survival studies of patients with stage IV disease are limited. The aim of this study was to evaluate trends in and factors affecting survival in a large population-based cohort of patients with newly diagnosed stage IV breast cancer.Patients and MethodsWe searched the Surveillance, Epidemiology, and End Results registry to identify female patients with stage IV breast cancer diagnosed between 1988 and 2003. Patients were divided into three groups according to year of diagnosis (1988 to 1993, 1994 to 1998, and 1999 to 2003). Survival outcomes were estimated by the Kaplan-Meier method, and Cox models were fit to determine the characteristics independently associated with survival.ResultsWe identified 15,438 patients. Median age was 62 years. Median follow-up was 16 months, 18 months, and 11 months in periods 1988 to 1993, 1994 to 1998, and 1999 to 2003, respectively. Median breast cancer-specific survival was 23 months. In the multivariate model, earlier year of diagnosis, grade 3 disease, increasing age, being unmarried, hormone receptor-negative disease, and no surgery were all independently associated with worse overall and breast cancer-specific survival. With each successive year of diagnosis, black patients had an increasingly greater risk of death compared with white patients (hazard ratio, 1.03; 95% CI, 1.00 to 1.06; P = .031).ConclusionThe survival of patients with newly diagnosed stage IV breast cancer has modestly improved over time, but these data suggest that the disparity in survival between black and white patients has increased.