The prognostic contribution of clinical breast cancer subtype, age, and race among patients with breast cancer brain metastases.
The prognostic contribution of clinical breast cancer subtype, age, and race among patients with breast cancer brain metastases.
复制标题
DOI：
10.1002/cncr.25746
复制
发表时间：
2011-04-15
期刊：
影响因子：
6.2
通讯作者：
Carey, Lisa A.
中科院分区：
文献类型：
--
作者：
Anders, Carey K.;Deal, Allison M.;Miller, C. Ryan;Khorram, Carmen;Meng, Hong;Burrows, Emily;Livasy, Chad;Fritchie, Karen;Ewend, Matthew G.;Perou, Charles M.;Carey, Lisa A.
三阴性乳腺癌（TNBC）引起的脑转移（BM）预示着预后不良。TNBC在绝经前和非裔美国人（AA）患者中更常见;两者也会导致预后不良。在一项单一机构队列研究中，我们试图确定TN BCBM的不良结局是否更能反映高风险人群或亚型本身。乳腺癌数据库确定了1988 - 2008年诊断为BCBM的患者。BC亚型由IHC指定：HR+（激素受体，ER+和/或PR+）/HER 2 −、HR+/HER 2+、HR−/HER 2+和TN（ER−/PR−/HER 2 −）。使用Kaplan-Meier方法和考克斯回归，按亚型、年龄（< vs ≥ 40岁）和种族（AA vs非AA）评价生存和复发模式。在119例BCBM患者中，33%为AA，31%年龄< 40岁。在98例患者中证实了BC亚型：30% HR+/HER 2 −，21% HR+/HER 2+，18% HR−/HER 2+，31% TN。BM后的存活率受亚型影响（p=0.002），TNBC的存活率最短（0.24年，CI 0.17 - 0.48）。BM后生存率无年龄（p=0.84）或种族特异性（p=0.09）差异;按年龄和种族进行亚型分层显示无差异（所有，p > 0.1）。当校正种族、年龄、CNS病变数量和BC亚型后，BCBM后接受全身治疗是BCBM后生存的重要预测因素（HR = 0.29，p=0.002）。无论种族和年龄如何，TNBC均赋予BM后的高死亡风险，这支持了对能够控制所有种族和年龄的颅内和颅外TNBC的新型药物的需求。
Brain metastases (BM) arising from Triple-negative breast cancer (TNBC) portend poor prognosis. TNBC is more common in premenopausal and African-American (AA) patients; both also confer poor prognosis. In a single institution cohort study, we sought to determine if inferior outcome of TN BCBM is more reflective of a higher-risk population or subtype itself. The UNC Breast Cancer Database identified pts with BCBM diagnosed 1988 – 2008. BC subtype was assigned by IHC: HR+ (hormone receptor, ER+ and/or PR+)/HER2−, HR+/HER2+, HR−/HER2+ and TN (ER−/PR−/HER2−). Survival and recurrence patterns were evaluated by subtype, age (< vs ≥ 40 years) and race (AA vs non-AA) using the Kaplan-Meier method and Cox regression. Among 119 patients with BCBM, 33% were AA and 31% aged < 40 yrs. BC subtype was confirmed in 98 patients: 30% HR+/HER2−, 21% HR+/HER2+, 18% HR−/HER2+, 31% TN. Survival after BM was impacted by subtype (p=0.002), shortest for TNBC (0.24 yrs, CI 0.17 – 0.48). There were no age- (p=0.84) or race-specific (p=0.09) differences in survival after BM; stratification of subtypes by age and race revealed no difference (all, p > 0.1). Receipt of systemic therapy after BCBM was an important predictor of survival following BCBM (HR = 0.29, p=0.002) when adjusted for race, age, number of CNS lesions and BC subtype. TNBC confers a high risk of death following BM regardless of race and age supporting the need for novel agents capable of controlling both intra- and extracranial TNBC across all races and ages.
登录
查看更多内容
影响因子：
11.2
作者：
Smid, Marcel;Wang, Yixin;Martens, John W. M.
通讯作者：
Martens, John W. M.
DOI：
10.1073/pnas.0932692100
发表时间：
2003-07-08
影响因子：
11.1
作者：
Sorlie, T;Tibshirani, R;Botstein, D
通讯作者：
Botstein, D
DOI：
10.1016/s0360-3016(02)04476-0
发表时间：
2003-04-01
影响因子：
7
作者：
Engel, J;Eckel, R;Hölzel, D
通讯作者：
Hölzel, D
影响因子：
45.3
作者：
Harvey, JM;Clark, GM;Allred, DC
通讯作者：
Allred, DC
影响因子：
--
作者：
Li, CI;Malone, KE;Daling, JR
通讯作者：
Daling, JR