Characteristics and Outcomes of Patients With Breast Cancer With Leptomeningeal Metastasis.
Characteristics and Outcomes of Patients With Breast Cancer With Leptomeningeal Metastasis.
复制标题
患有脑膜转移的乳腺癌患者的特征和结局。
DOI：
10.1016/j.clbc.2016.07.002
复制
发表时间：
2017-02
影响因子：
3.1
通讯作者：
Seidman AD
中科院分区：
文献类型：
--
作者：
Morikawa A;Jordan L;Rozner R;Patil S;Boire A;Pentsova E;Seidman AD
Disease presentation, prognostic factors, and treatment patterns for breast cancer patients with leptomeningeal metastasis are not well-characterized. In this study, we examined patient characteristics and prognostic factors for survival after a diagnosis of leptomeningeal metastasis. 318 consecutive breast cancer patients diagnosed with leptomeningeal metastasis from January 1998 to December 2013 at Memorial Sloan Kettering Cancer Center were identified. Clinico-pathologic and treatment information were obtained by retrospective review. Associations with time from leptomeningeal diagnosis to death were evaluated by Kaplan-Meier curves, log-rank tests, and Cox proportional hazard models. Of the 318 patients, 44% were HR+HER2−,18% HR+HER2+, 8.5% HR−HER2+, and 25.5% triple negative; 4% had missing information. The median survival was 3.5 months (95% CI: 3.0, 4.0) with 63 patients (20%) surviving greater than 1 year. Recent diagnosis (after 2006), HER2+ subtype, higher performance status, cranial only involvement, and no evidence of non-central nervous system disease were independently associated with improved survival in multivariate analysis. Despite the improvement noted with more recent year of diagnosis, survival following a diagnosis of leptomeningeal metastasis remains poor. Similar to patients with parenchymal brain metastasis only, the survival differs among difference receptor subtypes. A closer examination to identify factors, such as introduction of new systemic therapies that may contribute to longer-term survival may provide insight to improve management of these patients. In addition, factors we identified that are associated with survival may be considered as stratification variables in the design of future randomized clinical trials in this population. A retrospective cohort study of 318 breast cancer patients with leptomeningeal metastases was conducted to describe patient characteristics and outcomes.. Independent factors associated with survival after the diagnosis of leptomeningeal metastases were identified. Such information is useful in management and in clinical trial development of breast cancer patients with leptomeningeal metastases.
