Bianca Rogoz1, Agathe Houzé de l'Aulnoit2, Alain Duhamel3, Denis Houzé de l'Aulnoit2. 1. Departement of Obstetrics and Gynaecology, Saint Vincent de Paul Hospital, Catholic University of Lille, Lille, France. Electronic address: rogoz.bianca@ghicl.net. 2. Departement of Obstetrics and Gynaecology, Saint Vincent de Paul Hospital, Catholic University of Lille, Lille, France. 3. Laboratory of Biostatistics, CERIM, Lille, France.
Abstract
BACKGROUND: Metastatic breast cancer is generally considered an incurable disease. In our study we aimed to detect a time trend of survival over the past 30 years and account for time-varying effects of the prognostic factors. PATIENTS AND METHODS: A total of 446 patients diagnosed with breast cancer at Saint Vincent de Paul Hospital, Lille, France between 1977 and 2013 who developed metastatic disease after a disease-free interval longer than 3 months and were followed-up for outcome. Data were analyzed using the Cox proportional hazards model and presented as hazard ratios (HRs). RESULTS: A monotonic time trend of survival was detected: a 2.6% lower risk of death for each increasing year over the past 30 years. Three prognostic factors had time-varying effects; the liver first metastasis (HR during the first 16 months of follow-up: 2.26; 95% confidence interval [CI], 1.65-3.11), the bone first metastasis (HR during the first 24 months of follow-up: 0.56; 95% CI, 0.43-0.74), and the disease-free interval (HR during the first 16 months of follow-up: 0.90; 95% CI, 0.85-0.95). The brain first metastasis, multiple first metastases, the lymph node ratio, and estrogen receptor status had a constant effect over time. CONCLUSION: In our study we detected a constant time trend of improvement in prognosis of metastatic breast cancer patients over the past 30 years and identified prognostic factors with time-varying effects.
BACKGROUND:Metastatic breast cancer is generally considered an incurable disease. In our study we aimed to detect a time trend of survival over the past 30 years and account for time-varying effects of the prognostic factors. PATIENTS AND METHODS: A total of 446 patients diagnosed with breast cancer at Saint Vincent de Paul Hospital, Lille, France between 1977 and 2013 who developed metastatic disease after a disease-free interval longer than 3 months and were followed-up for outcome. Data were analyzed using the Cox proportional hazards model and presented as hazard ratios (HRs). RESULTS: A monotonic time trend of survival was detected: a 2.6% lower risk of death for each increasing year over the past 30 years. Three prognostic factors had time-varying effects; the liver first metastasis (HR during the first 16 months of follow-up: 2.26; 95% confidence interval [CI], 1.65-3.11), the bone first metastasis (HR during the first 24 months of follow-up: 0.56; 95% CI, 0.43-0.74), and the disease-free interval (HR during the first 16 months of follow-up: 0.90; 95% CI, 0.85-0.95). The brain first metastasis, multiple first metastases, the lymph node ratio, and estrogen receptor status had a constant effect over time. CONCLUSION: In our study we detected a constant time trend of improvement in prognosis of metastatic breast cancerpatients over the past 30 years and identified prognostic factors with time-varying effects.
Authors: Jennifer L Caswell-Jin; Sylvia K Plevritis; Lu Tian; Christopher J Cadham; Cong Xu; Natasha K Stout; George W Sledge; Jeanne S Mandelblatt; Allison W Kurian Journal: JNCI Cancer Spectr Date: 2018-12-24
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