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基于人群的女性新发乳腺癌肝转移研究。

A Population-Based Study on Liver Metastases in Women with Newly Diagnosed Breast Cancer.

机构信息

Research Center for Clinical Pharmacology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

Cancer Epidemiol Biomarkers Prev. 2019 Feb;28(2):283-292. doi: 10.1158/1055-9965.EPI-18-0591. Epub 2018 Nov 28.

Abstract

BACKGROUND

Population-based estimates for prognosis among patients with liver metastases in newly diagnosed breast cancer are not generally available.

METHODS

Within the Surveillance, Epidemiology and End Results (SEER) database, we identified 298,370 patients with breast cancer and 4,285 patients diagnosed with initial liver metastases between 2010 and 2014. Data were stratified according to subtype, age, and race. Multivariate logistic and Cox regression were used to identify predictors for the presence of initial liver metastases and prognostic factors, respectively. Kaplan-Meier procedure was used for survival analysis.

RESULTS

A total of 4,285 patients with initial liver metastases (1.4% of the entire cohort, 29.6% of the subset with metastatic disease) were identified. Patients with hormone receptor (HR)-negative human epidermal growth factor receptor 2 (HER2)-positive (4.4% of entire cohort, 52.5% of patients with metastatic disease to any distant site) and HR-positive HER2-positive (2.8% of entire cohort, 40.4% of patients with metastatic disease to any distant site) subtypes had highest incidence proportions. The median survival of patients with liver metastases in the entire cohort was 15.0 months. Patients with HR-positive HER2-positive subtype showed the longest median survival (31.0 months); however, patients with triple-negative subtype showed the shortest median survival (8.0 months).

CONCLUSIONS

Our findings provide population-based estimates of epidemiologic characteristics and prognosis in breast cancer patients diagnosed with initial liver metastases.

IMPACT

This study lends support to the diagnosis of the liver among patients at high risk of liver metastases, including those with HER2-positive and other systemic metastases.

摘要

背景

在新诊断的乳腺癌患者中,基于人群的肝转移预后估计通常不可用。

方法

在监测、流行病学和最终结果 (SEER) 数据库中,我们确定了 298370 名乳腺癌患者和 2010 年至 2014 年间诊断为初始肝转移的 4285 名患者。数据按亚型、年龄和种族分层。使用多变量逻辑和 Cox 回归分别确定初始肝转移的存在和预测因素以及预后因素。Kaplan-Meier 程序用于生存分析。

结果

共确定了 4285 名初始肝转移患者(整个队列的 1.4%,远处转移患者的 29.6%)。激素受体 (HR) 阴性人表皮生长因子受体 2 (HER2) 阳性(整个队列的 4.4%,远处任何部位转移患者的 52.5%)和 HR 阳性 HER2 阳性(整个队列的 2.8%,远处任何部位转移患者的 40.4%)亚型的患者具有最高的发病比例。整个队列中肝转移患者的中位生存时间为 15.0 个月。HR 阳性 HER2 阳性亚型的患者中位生存时间最长(31.0 个月);然而,三阴性亚型的患者中位生存时间最短(8.0 个月)。

结论

我们的研究结果提供了基于人群的新诊断为初始肝转移的乳腺癌患者的流行病学特征和预后估计。

影响

这项研究支持对包括 HER2 阳性和其他全身转移在内的高肝转移风险患者进行肝脏诊断。

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