Bertaut A, Mounier M, Desmoulins I, Guiu S, Beltjens F, Darut-Jouve A, Ponnelle T, Arnould L, Arveux P
Côte d'Or Breast Cancer Registry, CGFL, Dijon, France.
EA 4184 Centre d'Epidémiologie des populations, University of Burgundy, Dijon, France.
Eur J Cancer Care (Engl). 2015 Nov;24(6):920-8. doi: 10.1111/ecc.12306. Epub 2015 Mar 10.
We aim to describe trends in net survival (NS) and to assess the prognostic factors among women with de novo metastatic breast cancer (MBC) according to human epidermal growth factor receptor 2 (HER2) and hormone receptor (HR) status. Data on women suffering from de novo MBC and diagnosed from 1998 to 2009 were provided by the Côte-d'Or breast cancer registry. NS was described using the Pohar Perme estimator and prognostic factors were investigated in a generalised linear model. We identified 232 patients (mean age = 64.7). Median NS was 29.2 months, 1- and 5-year NS were 76% and 26% respectively. The survival trend in patients with HER2-positive tumours who did not receive trastuzumab was similar to that in women with triple-negative tumours. A higher relative excess risk of death by cancer was observed for high-grade tumours [RER, relative excess rates = 1.76 (95% CI, confidence intervals: 1.17-2.62) for Scarff Bloom Richardson grade 3 vs. 1 + 2], while a lower risk was observed for luminal tumours [RER = 0.49 (95% CI: 0.27-0.89)] and HER2-positive tumours treated with trastuzumab [RER = 0.28 (95% CI: 0.14-0.59)], both compared with triple-negative tumours. Surgery of the primary tumour was associated with better survival [RER = 0.43 (95% CI: 0.28-0.68)]. With half of the women dead before 29 months, stage IV breast cancer still has a bleak outlook. Progress should continue with new target therapies for both HR and HER2 receptors.
我们旨在描述净生存（NS）趋势，并根据人表皮生长因子受体2（HER2）和激素受体（HR）状态评估初发性转移性乳腺癌（MBC）女性患者的预后因素。科多尔省乳腺癌登记处提供了1998年至2009年期间初发性MBC女性患者的数据。使用波哈尔·佩尔梅估计器描述净生存情况，并在广义线性模型中研究预后因素。我们确定了232例患者（平均年龄=64.7岁）。中位净生存时间为29.2个月，1年和5年净生存率分别为76%和26%。未接受曲妥珠单抗治疗的HER2阳性肿瘤患者的生存趋势与三阴性肿瘤女性患者相似。高级别肿瘤的癌症相对超额死亡风险更高[相对超额率（RER）：斯卡夫-布卢姆-理查森3级与1+2级相比为1.76（95%置信区间：1.17-2.62）]，而管腔型肿瘤[RER=0.49（95%置信区间：0.27-0.89）]和接受曲妥珠单抗治疗的HER阳性肿瘤[RER=0.28（95%置信区间：0.14-0.59）]的风险均低于三阴性肿瘤。原发肿瘤手术与更好的生存相关[RER=0.43（95%置信区间：0.28-0.68）]。由于一半的女性在29个月前死亡，IV期乳腺癌的前景仍然黯淡。应继续推进针对HR和HER2受体的新靶向治疗。
