Bhoo-Pathy Nirmala, Verkooijen Helena Marieke, Tan Ern-Yu, Miao Hui, Taib Nur Aishah Mohd, Brand Judith S, Dent Rebecca A, See Mee-Hoong, Subramaniam ShriDevi, Chan Patrick, Lee Soo-Chin, Hartman Mikael, Yip Cheng-Har
Julius Centre University of Malaya, Centre for Evidence Based Medicine and Clinical Epidemiology, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Lembah Pantai, Kuala Lumpur, Malaysia.
Julius Center for Health Sciences and Primary Care, University Medical Center, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Sci Rep. 2015 Nov 5;5:16252. doi: 10.1038/srep16252.
Up to 25% of breast cancer patients in Asia present with de novo metastatic disease. We examined the survival trends of Asian patients with metastatic breast cancer over fifteen years. The impact of changes in patient's demography, tumor characteristics, tumor burden, and treatment on survival trend were examined. Patients with de novo metastatic breast cancer from three hospitals in Malaysia and Singapore (N = 856) were grouped by year of diagnosis: 1996-2000, 2001-2005 and 2006-2010. Step-wise multivariable Poisson regression was used to estimate the contribution of above-mentioned factors on the survival trend. Proportions of patients presenting with metastatic breast cancer were 10% in 1996-2000, 7% in 2001-2005, and 9% in 2006-2010. Patients in 2006-2010 were significantly older, appeared to have higher disease burden, and received more chemotherapy, endocrine therapy, and surgery of primary tumor. The three-year relative survival in the above periods were 20·6% (95% CI: 13·9%-28·2%), 28·8% (95% CI: 23·4%-34·2%), and 33·6% (95% CI: 28·8%-38·5%), respectively. Adjustment for treatment considerably attenuated the relative excess risk of mortality in recent years, compared to other factors. Substantial improvements in survival were observed in patients with de novo metastatic breast cancer in this study.
在亚洲，高达25%的乳腺癌患者初诊时即有转移性疾病。我们研究了亚洲转移性乳腺癌患者15年的生存趋势。考察了患者人口统计学、肿瘤特征、肿瘤负荷和治疗的变化对生存趋势的影响。来自马来西亚和新加坡三家医院的初诊转移性乳腺癌患者（N = 856）按诊断年份分组：1996 - 2000年、2001 - 2005年和2006 - 2010年。采用逐步多变量泊松回归来估计上述因素对生存趋势的影响。初诊为转移性乳腺癌的患者比例在1996 - 2000年为10%，2001 - 2005年为7%，2006 - 2010年为9%。2006 - 2010年的患者年龄显著更大，疾病负担似乎更高，接受的化疗、内分泌治疗以及原发肿瘤手术更多。上述时期的三年相对生存率分别为20.6%（95%CI：13.9% - 28.2%）、28.8%（95%CI：23.4% - 34.2%）和33.6%（95%CI：28.8% - 38.5%）。与其他因素相比，治疗调整在很大程度上降低了近年来相对过高的死亡风险。本研究中观察到初诊转移性乳腺癌患者的生存率有显著提高。
