Chang Hannah L, Cao Meng, Lim Mir, Moscowitz Anna, Gao Ang, Weiss Ariana, Brown Ariel, Spanbauer Danielle, Uwera Giselle, Oh Jaeyoung, Ladner Jonathan, Wu Nathaniel, Okanlawon Priscilla, Olivo Reynaldo, Iyer Ruchita, Engidaw Yemariamwork, Reddy Sangeetha M, McArthur Heather L, Xu Lily, Mohta Sakshi, Maues Julia, Hodgdon Christine, Chinea Luis, Lei Katherine, Huang Shao-Po, Bansal Rani, Chan Isaac S
Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Commun Med (Lond). 2025 Aug 5;5(1):333. doi: 10.1038/s43856-025-01011-5.
The Dallas Metastatic Cancer Study is a clinical database established to examine local trends associated with the diagnosis and treatment of de novo metastatic breast cancer and identify factors for further evaluation. Clinical characteristics of patients with de novo metastatic breast cancer are often underreported in the literature.
We report data from 2010 to 2021 for patients with de novo metastatic breast cancer along with the impact of clinical variables such as age, BMI, race and ethnicity, insurance status, hypertension, diabetes, and site of metastasis with survival analysis with respect to subtype.
Black race (HR 2.07, 95% CI 1.56-2.74), public insurance (HR 1.64, 95% CI 1.23-2.18), no insurance (HR 1.69, 95% CI 1.24-2.31), hypertension (HR 1.50, 95% CI 1.18-1.91), diabetes (HR 1.69, 95% CI 1.24-2.31), and visceral metastases including brain (HR 1.68, 95% CI 1.20-2.36), liver (HR 1.80, 95% CI 1.40-2.30), and lung (HR 1.50, 95% CI 1.17-1.92) were associated with increased mortality and remained significant when controlled for subtype. In the multivariate analysis, diabetes (HR 1.74, 95% CI 1.22-2.49) and presence of liver metastases (HR 1.97, 95% CI 1.43-2.49) remained independently associated with decreased overall survival regardless of subtype and other variables. Patients diagnosed at 40 and younger were less likely to have hypertension and diabetes, more likely to be Hispanic, and showed distinct subtype distributions compared to those diagnosed at older ages.
Future work will focus on these associations at the patient level to identify targets for intervention.
达拉斯转移性癌症研究是一个临床数据库，旨在研究与新发转移性乳腺癌诊断和治疗相关的局部趋势，并确定需进一步评估的因素。新发转移性乳腺癌患者的临床特征在文献中常常报道不足。
我们报告了2010年至2021年新发转移性乳腺癌患者的数据，以及年龄、体重指数、种族和族裔、保险状况、高血压、糖尿病和转移部位等临床变量对生存分析的影响，并按亚型进行了分析。
黑人种族（风险比2.07，95%置信区间1.56 - 2.74）、公共保险（风险比1.64，95%置信区间1.23 - 2.18）、无保险（风险比1.69，95%置信区间1.24 - 2.31）、高血压（风险比1.50，95%置信区间1.18 - 1.91）、糖尿病（风险比1.69，95%置信区间1.24 - 2.31）以及包括脑转移（风险比1.68，95%置信区间1.20 - 2.36）、肝转移（风险比1.80，95%置信区间1.40 - 2.30）和肺转移（风险比1.50，95%置信区间1.17 - 1.92）在内的内脏转移均与死亡率增加相关，在控制亚型后仍具有显著性。在多变量分析中，糖尿病（风险比1.74，95%置信区间1.22 - 2.49）和肝转移的存在（风险比1.97，95%置信区间1.43 - 2.49）无论亚型和其他变量如何，均与总体生存率降低独立相关。与年龄较大时被诊断的患者相比，40岁及以下被诊断的患者患高血压和糖尿病的可能性较小，更有可能是西班牙裔，并且显示出不同的亚型分布。
未来的工作将聚焦于患者层面的这些关联，以确定干预靶点。
