Department of Gynecology and Gynecological Oncology, EUSOMA-Breast Unit, HSK, Dr. Horst Schmidt Kliniken, Wiesbaden.
Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg.
Ann Oncol. 2011 Jul;22(7):1571-1581. doi: 10.1093/annonc/mdq625. Epub 2010 Nov 8.
Survival of patients suffering from cerebral metastases (CM) is limited. Identification of patients with a high risk for CM is warranted to adjust follow-up care and to evaluate preventive strategies.
Exploratory analysis of disease-specific parameter in patients with metastatic breast cancer (MBC) treated between 1998 and 2008 using cumulative incidences and Fine and Grays' multivariable regression analyses.
After a median follow-up of 4.0 years, 66 patients (10.5%) developed CM. The estimated probability for CM was 5%, 12% and 15% at 1, 5 and 10 years; in contrast, the probability of death without CM was 21%, 61% and 76%, respectively. A small tumor size, ER status, ductal histology, lung and lymph node metastases, human epidermal growth factor receptor 2 positive (HER2+) tumors, younger age and M0 were associated with CM in univariate analyses, the latter three being risk factors in the multivariable model. Survival was shortened in patient developing CM (24.0 months) compared with patients with no CM (33.6 months) in the course of MBC.
Young patients, primary with non-metastatic disease and HER2+ tumors, have a high risk to develop CM in MBC. Survival of patients developing CM in the course of MBC is impaired compared with patients without CM.
患有脑转移（CM）的患者的生存时间有限。需要识别出具有高 CM 风险的患者，以调整随访护理并评估预防策略。
使用累积发生率和 Fine 和 Grays 多变量回归分析，对 1998 年至 2008 年间治疗的转移性乳腺癌（MBC）患者的疾病特异性参数进行探索性分析。
在中位随访 4.0 年后，66 名患者（10.5%）发生了 CM。CM 的估计概率分别为 1 年、5 年和 10 年时的 5%、12%和 15%；相比之下，无 CM 死亡的概率分别为 21%、61%和 76%。肿瘤体积小、ER 状态、导管组织学、肺和淋巴结转移、人表皮生长因子受体 2 阳性（HER2+）肿瘤、年龄较小和 M0 在单变量分析中与 CM 相关，后三个是多变量模型中的危险因素。在 MBC 过程中发生 CM 的患者的生存时间（24.0 个月）短于未发生 CM 的患者（33.6 个月）。
年轻患者、原发非转移性疾病和 HER2+肿瘤患者在 MBC 中具有发生 CM 的高风险。在 MBC 过程中发生 CM 的患者的生存时间比未发生 CM 的患者差。
