New insights into patterns of first metastatic sites influencing survival of patients with hormone receptor-positive, HER2-negative breast cancer: a multicenter study of 271 patients

BMC Cancer

Shunji Kamigaki¹  Hiroki Osato¹  Junya Fujita¹  Jun Yamamura²  Hironobu Manabe³  Yukihiko Hashimoto³  Yoshifumi Komoike³  Wataru Shinzaki³  Yumiko Tanaka³ 

[1] Department of Surgery, Sakai City Medical Center, 1-1-1, Ebaraji-cho, Nishi-ku, 593-8304, Sakai City, Osaka, Japan;Department of Surgery, Sakai City Medical Center, 1-1-1, Ebaraji-cho, Nishi-ku, 593-8304, Sakai City, Osaka, Japan;Division of Breast and Endocrine Surgery, Department of Surgery, Kindai University Faculty of Medicine, 377-2, Ohnohigasi, 589-8511, Sayama City, Osaka, Japan;Division of Breast and Endocrine Surgery, Department of Surgery, Kindai University Faculty of Medicine, 377-2, Ohnohigasi, 589-8511, Sayama City, Osaka, Japan;

关键词: Breast cancer;    Recurrence;    Survival;    Hormone receptor-positive;    HER2-negative;    Metastatic pattern;   

DOI  :  10.1186/s12885-021-08219-3

来源: Springer

【 摘 要 】

BackgroundThe initial therapeutic strategy for hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer is based on the first metastatic site; however, little evidence is available regarding the influence of metastatic distribution patterns of first metastatic sites on prognosis. In this study, we aimed to identify the metastatic distribution patterns of first metastatic sites that significantly correlate with survival after recurrence.MethodsWe performed a retrospective review of records from 271 patients with recurrent metastatic HR+/HER2- breast cancer diagnosed between January 2000 and December 2015. We assessed survival after recurrence according to the metastatic distribution patterns of the first metastatic sites and identified significant prognostic factors among patients with single and multiple metastases.ResultsPrognosis was significantly better in patients with a single metastasis than in those with multiple metastases (median overall survival after recurrence: 5.86 years vs. 2.50 years, respectively, p < 0.001). No metastatic organ site with single metastasis was significantly associated with prognostic outcome, although single metastasis with diffuse lesions was an independent risk factor for worse prognosis (HR: 3.641; 95% CI: 1.856–7.141) and more easily progressing to multiple metastases (p = 0.002). Multiple metastases, including liver metastasis (HR: 3.145; 95% CI: 1.802–5.495) or brain metastasis (HR: 3.289; 95% CI: 1.355–7.937), were regarded as significant independent poor prognostic factors; however, multiple metastases not involving liver or brain metastasis were not significantly related to prognosis after recurrence.ConclusionsSingle metastases with diffuse lesions could more easily disseminate systemically and progress to multiple metastases, leading to a poor prognosis similar to multiple metastases. Our findings indicate that the reconsideration of the determinant factors of therapeutic strategies for first recurrence in HR+/HER2- breast cancer may be needed.

【 授权许可】

CC BY