Lin Shaoyan, Mo Hongnan, Li Yiqun, Guan Xiuwen, Chen Yimeng, Wang Zijing, Yuan Peng, Wang Jiayu, Luo Yang, Fan Ying, Cai Ruigang, Li Qiao, Chen Shanshan, Zhang Pin, Li Qing, Ma Fei, Xu Binghe
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Front Oncol. 2021 May 11;11:670723. doi: 10.3389/fonc.2021.670723. eCollection 2021.
The risk factors for morbidity and mortality in patients with breast cancer liver metastases (BCLM) upon initial metastatic breast cancer (MBC) diagnosis have not been adequately identified in Han population. Data of 3,161 female patients who were initially diagnosed with MBC from December 1991 to September 2019 and treated in the China National Cancer Center were extracted and a total of 2,263 MBC patients were included in our study, among which 550 patients had liver metastases. Multivariable logistic regression was performed to identify risk factors for the presence of liver metastases at initial MBC diagnosis. Univariable and multivariable Cox proportional hazards regression analyses were conducted to determine prognostic factors for the survival of BCLM patients. Patients with hormone receptor (HR)-negative, human epidermal growth factor receptor 2 (HER2)-positive (35.0% of the entire population) subtype had the highest incidence of liver metastases. stage IV breast cancer, HR-/HER2+ and HR+/HER2+ subtypes were associated with higher odds of liver metastases and patients with lung metastases had lower risk of liver metastases at initial MBC diagnosis. The median overall survival of BCLM patients was 31.4 months and BCLM patients with HR+/HER2- subtype had the longest survival of 38.2 months. Older age, worse performance status, later stage of initial breast cancer, triple-negative subtype and lung metastases were significantly associated with a poorer prognosis in BCLM patients. Our study offers insights into the incidence and prognosis of BCLM patients at initial MBC diagnosis in Han population.
在汉族人群中，初诊转移性乳腺癌（MBC）时，乳腺癌肝转移（BCLM）患者发病和死亡的危险因素尚未得到充分识别。提取了1991年12月至2019年9月在中国国家癌症中心初诊为MBC并接受治疗的3161例女性患者的数据，本研究共纳入2263例MBC患者，其中550例有肝转移。进行多变量逻辑回归以识别初诊MBC时肝转移的危险因素。进行单变量和多变量Cox比例风险回归分析以确定BCLM患者生存的预后因素。激素受体（HR）阴性、人表皮生长因子受体2（HER2）阳性（占全部人群的35.0%）亚型的患者肝转移发生率最高。IV期乳腺癌、HR-/HER2+和HR+/HER2+亚型与肝转移几率较高相关，初诊MBC时伴有肺转移的患者肝转移风险较低。BCLM患者的中位总生存期为31.4个月，HR+/HER2-亚型的BCLM患者生存期最长，为38.2个月。年龄较大、体能状态较差、初诊乳腺癌分期较晚、三阴性亚型和肺转移与BCLM患者预后较差显著相关。我们的研究为汉族人群初诊MBC时BCLM患者的发病率和预后提供了见解。
