Comparison of the clinicopathological characteristics and prognosis between Chinese patients with breast cancer with bone-only and non-bone-only metastasis
Comparison of the clinicopathological characteristics and prognosis between Chinese patients with breast cancer with bone-only and non-bone-only metastasis
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DOI：
10.3892/ol.2020.11953
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发表时间：
2020-08
期刊：
影响因子：
2.9
通讯作者：
Li Zhang;Jie Zhang;Zhijun Li;Yan-sheng Wu;Z. Tong
中科院分区：
文献类型：
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作者：
Li Zhang;Jie Zhang;Zhijun Li;Yan-sheng Wu;Z. Tong
骨是乳腺癌患者最常见的转移扩散部位。仅骨转移（BOM）患者是一个独特的群体。本研究的目的是比较BOM和非BOM患者的临床病理特征、生存率和预后因素。回顾了2008年1月至2017年12月期间在天津医科大学肿瘤研究所和医院（中国天津）接受治疗的1，290例转移性乳腺癌患者的临床数据。临床数据分为BOM组（n=208例）和非BOM组（n= 1，082例）。与非BOM组患者相比，BOM患者的无病生存期、无进展生存期（PFS）和总生存期（OS）较长。激素受体（HR）状态和转移灶数量是BOM组PFS的显著影响因素。此外，BOM组患者的HR状态、骨转移部位和骨转移数量与OS显著相关。在非BOM组中，诊断转移时的年龄、HR状态和肿瘤分期与OS显著相关。在BOM组中，HR+/人表皮生长因子受体2（HER 2）-肿瘤患者的预后最好。在非BOM组中，HR+/HER 2 −和HER 2+肿瘤患者的预后有所改善。在BOM伴HR+/HER 2 −亚组中，接受内分泌治疗或序贯治疗（先化疗后内分泌治疗）的患者的PFS和OS较单独接受化疗的患者显著改善（P<0.05）。骨转移数目与骨相关事件显著相关（P<0.001）。BOM组中最常见的继发性转移部位是肝脏。BOM组患者的预后较非BOM组改善。HR-和多发性骨转移，以及轴向和轴向骨转移的联合，与BOM患者的不良预后显著相关。对于HR+/HER 2 − BOM亚组的患者，单用内分泌治疗可获得令人满意的结果。
Bone is the most common site of metastatic spread in patients with breast cancer. Patients with bone-only metastasis (BOM) are a unique group. The aim of the present study was to compare the clinicopathological characteristics, survival and prognostic factors of patients with BOM and non-BOM. The clinical data of 1,290 patients with metastatic breast cancer treated at the Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) between January 2008 and December 2017 were reviewed. The clinical data were divided into a BOM group (n=208 cases) and a non-BOM group (n=1,082 cases). Patients with BOM had longer disease-free survival, progression-free survival (PFS) and overall survival (OS) compared with patients in the non-BOM group. The hormone receptor (HR) status and number of metastases were significant influencing factors of PFS in the BOM group. Furthermore, the HR status, location of bone metastasis and number of bone metastases were significantly associated with OS of patients in the BOM group. Age at diagnosis of metastasis, HR status and tumor stage were significantly associated with OS in the non-BOM group. In the BOM group, patients with HR+/human epidermal growth factor receptor 2 (HER2)− tumors had the most favorable prognosis. In the non-BOM group, patients with HR+/HER2− and HER2+ tumors had improved prognosis. In the BOM with HR+/HER2− subgroup, the PFS and OS of patients receiving endocrine therapy or sequential therapy (chemotherapy followed by endocrine therapy) was significantly improved compared with those receiving chemotherapy alone (P<0.05). Skeletal-related events were significantly associated with the number of bone metastases (P<0.001). The most common secondary metastatic site in the BOM group was the liver. The prognosis of the patients in the BOM group was improved compared with that in the non-BOM patients. HR− and multiple bone metastases, as well as combined axial and appendicular bone metastases, were significantly associated with poor prognosis in the patients with BOM. For patients in the HR+/HER2− BOM subgroup, endocrine therapy alone resulted in satisfactory results.