Department of Surgery, Gangnam Severance Hospital, Yonsei University Medical College, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea.
Yonsei Med J. 2013 Sep;54(5):1168-77. doi: 10.3349/ymj.2013.54.5.1168.
Bone is the most frequent site of metastasis among breast cancer patients. We investigated prognostic factors affecting survival following bone-only metastasis in breast cancer patients.
The medical records of breast cancer patients who were treated and followed at Gangnam Severance Hospital retrospectively reviewed to identify patients with bone-only metastasis.
The median time from the diagnosis of bone-only metastasis to the last follow-up or death was 55.2 [95% confidence interval (CI), 38.6-71.9] months. The Kaplan-Meier overall survival estimate at 10 years for all patients was 34.9%. In the multivariate Cox regression model, bisphosphonate treatment [hazard ratio=0.18; 95% CI, 0.07-0.43], estrogen receptor positivity (hazard ratio=0.51; 95% CI, 0.28-0.94), and solitary bone metastasis (hazard ratio=0.32; 95% CI, 0.14-0.72) were significantly associated with longer overall survival in the bone-only recurrence group. Among the treatment modalities, only bisphosphonate treatment was identified as a significant prognostic factor.
Identifying the factors influencing breast cancer mortality after bone-only metastasis will help clarify the clinical course and improve the treatment outcome for patients with breast cancer and bone-only metastasis. Bisphosphonates, as a significant prognostic factor, warrant further investigation.
在乳腺癌患者中,骨骼是转移最常见的部位。我们研究了影响乳腺癌患者仅有骨转移后生存的预后因素。
回顾性分析在江南狎鸥亭Severance 医院治疗和随访的乳腺癌患者的病历,以确定仅有骨转移的患者。
从仅有骨转移的诊断到最后一次随访或死亡的中位时间为 55.2 个月(95%置信区间[CI]:38.6-71.9)。所有患者的 10 年 Kaplan-Meier 总生存率估计值为 34.9%。在多变量 Cox 回归模型中,双膦酸盐治疗[风险比=0.18;95%CI:0.07-0.43]、雌激素受体阳性[风险比=0.51;95%CI:0.28-0.94]和单发骨转移[风险比=0.32;95%CI:0.14-0.72]与仅有骨复发组的总生存时间延长显著相关。在治疗方式中,只有双膦酸盐治疗被确定为显著的预后因素。
确定影响乳腺癌仅有骨转移后死亡率的因素将有助于阐明临床过程并改善仅有骨转移的乳腺癌患者的治疗结果。双膦酸盐作为一个显著的预后因素,值得进一步研究。