Sun Shujuan, Man Xiaochu, Zhou Dongdong, Zheng Fangchao, Zhao Jiuda, Chen Xuesong, Liu Tong, Huang Jie, Tan Qiaorui, Li Na, Li Huihui
Department of Breast Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai University & Affiliated Cancer Hospital of Qinghai University, Xining, China.
Cancer Med. 2023 Sep;12(18):18850-18860. doi: 10.1002/cam4.6509. Epub 2023 Sep 8.
The prognostic outcomes of metastasis patterns in patients with de novo metastatic breast cancer (dnMBC) of different ages are unknown. Our study used a large-scale data to investigate the metastasis patterns and prognostic features in dnMBC of different ages.
Total 24,698 women with dnMBC in the Surveillance, Epidemiology and End Results database (2010-2018) were divided into three groups by age. Chi-squared test was used to compare metastasis patterns and logistic regression was performed to investigate the risk of age and specific organ metastases. Kaplan-Meier survival curves were used to compare the overall survival.
In three groups, young group had the largest proportion of liver metastases (35.2% vs. 28.2% vs. 21.1%, p < 0.001), and elderly group had the largest proportion of lung metastases (22.6% vs. 30.0% vs. 35.0%, p < 0.001) and the lowest proportion of bone metastases (65.7% vs. 67.6% vs. 64.4%, p < 0.001). In young group, patients with liver metastases had better prognosis than patients with lung metastases (MST: 34 months vs. 29 months, p = 0.041), but in middle-aged and elderly groups, the prognosis of lung metastases was better than that of liver metastases (MST in middle-aged group: 24 months vs. 20 months, p = 0.002; MST in elderly group: 12 months vs. 6 months, p < 0.001).
DnMBC patients at different age have distinct metastasis patterns and prognostic features. The findings lend support to consideration of tailored management and surveillance strategies for different age patients.
不同年龄的初发性转移性乳腺癌(dnMBC)患者转移模式的预后结果尚不清楚。我们的研究使用大规模数据调查不同年龄dnMBC患者的转移模式和预后特征。
监测、流行病学和最终结果数据库(2010 - 2018年)中总共24,698例dnMBC女性患者按年龄分为三组。采用卡方检验比较转移模式,并进行逻辑回归分析以研究年龄和特定器官转移的风险。采用Kaplan-Meier生存曲线比较总生存期。
在三组中,年轻组肝转移比例最高(35.2%对28.2%对21.1%,p < 0.001),老年组肺转移比例最高(22.6%对30.0%对35.0%,p < 0.001),骨转移比例最低(65.7%对67.6%对64.4%,p < 0.001)。在年轻组中,肝转移患者的预后优于肺转移患者(中位生存期:34个月对29个月,p = 0.041),但在中年组和老年组中,肺转移的预后优于肝转移(中年组中位生存期:24个月对20个月,p = 0.002;老年组中位生存期:12个月对6个月,p < 0.001)。
不同年龄dnMBC患者有不同的转移模式和预后特征。这些发现支持为不同年龄患者考虑量身定制的管理和监测策略。