Trends in presentation, management and survival of patients with de novo metastatic breast cancer in a Southeast Asian setting
Trends in presentation, management and survival of patients with de novo metastatic breast cancer in a Southeast Asian setting
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DOI：
10.1038/srep16252
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发表时间：
2015-11-05
影响因子：
4.6
通讯作者：
Yip, Cheng-Har
中科院分区：
文献类型：
--
作者：
Bhoo-Pathy, Nirmala;Verkooijen, Helena Marieke;Yip, Cheng-Har
亚洲高达25%的乳腺癌患者存在新发转移性疾病。我们研究了亚洲转移性乳腺癌患者15年的生存趋势。研究了患者人口统计学、肿瘤特征、肿瘤负荷和治疗变化对生存趋势的影响。来自马来西亚和新加坡三家医院的原发转移性乳腺癌患者（N = 856）按诊断年份分组：1996-2000年、2001-2005年和2006-2010年。采用逐步多变量Poisson回归分析，估计上述因素对生存趋势的贡献。1996-2000年，转移性乳腺癌患者比例为10%，2001-2005年为7%，2006-2010年为9%。2006-2010年的患者年龄明显偏大，疾病负担似乎更高，接受更多的化疗、内分泌治疗和原发肿瘤手术。3年相对生存率分别为20.6%（95%CI：13.9%~ 28.2%）、28.8%（95%CI：23.4%~ 34.2%）和33.6%（95%CI：28.8%~ 38.5%）。与其他因素相比，近年来治疗调整大大降低了死亡率的相对过高风险。在本研究中，在原发转移性乳腺癌患者中观察到生存期的显著改善。
Up to 25% of breast cancer patients in Asia present with de novo metastatic disease. We examined the survival trends of Asian patients with metastatic breast cancer over fifteen years. The impact of changes in patient's demography, tumor characteristics, tumor burden, and treatment on survival trend were examined. Patients with de novo metastatic breast cancer from three hospitals in Malaysia and Singapore (N = 856) were grouped by year of diagnosis: 1996-2000, 2001-2005 and 2006-2010. Step-wise multivariable Poisson regression was used to estimate the contribution of above-mentioned factors on the survival trend. Proportions of patients presenting with metastatic breast cancer were 10% in 1996-2000, 7% in 2001-2005, and 9% in 2006-2010. Patients in 2006-2010 were significantly older, appeared to have higher disease burden, and received more chemotherapy, endocrine therapy, and surgery of primary tumor. The three-year relative survival in the above periods were 20.6% (95% CI: 13.9%-28.2%), 28.8% (95% CI: 23.4%-34.2%), and 33.6% (95% CI: 28.8%-38.5%), respectively. Adjustment for treatment considerably attenuated the relative excess risk of mortality in recent years, compared to other factors. Substantial improvements in survival were observed in patients with de novo metastatic breast cancer in this study.