Evaluation of clinical parameters influencing the development of bone metastasis in breast cancer

BMC Cancer

Research Article

Rolf Kreienberg¹  Wolfgang Janni¹  Lukas Schwentner¹  Roland Stein²  Mathias Krockenberger²  Catharina Bartmann²  Joachim Diessner²  Sebastian Häusler²  Achim Wöckel²  Tanja Stüber²  Manfred Wischnewsky³  Maria Blettner⁴ 

[1] Department for Obstetrics and Gynecology, University of Ulm Medical School, Prittwitzstr. 43, 89075, Ulm, Germany;Department for Obstetrics and Gynecology, University of Würzburg Medical School, Josef-Schneider-Str. 4, 97080, Würzburg, Germany;Faculty of Mathematics and Computer Science, University of Bremen, Universitätsallee GW1, 28359, Bremen, Germany;Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), University of Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany;

关键词: Breast cancer;    Bone metastases;    Skeleton;    Breast cancer subtypes;    BRENDA;   

DOI  :  10.1186/s12885-016-2345-7

 received in 2015-09-07, accepted in 2016-05-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe development of metastases is a negative prognostic parameter for the clinical outcome of breast cancer. Bone constitutes the first site of distant metastases for many affected women. The purpose of this retrospective multicentre study was to evaluate if and how different variables such as primary tumour stage, biological and histological subtype, age at primary diagnosis, tumour size, the number of affected lymph nodes as well as grading influence the development of bone-only metastases.MethodsThis retrospective German multicentre study is based on the BRENDA collective and included 9625 patients with primary breast cancer recruited from 1992 to 2008. In this analysis, we investigated a subgroup of 226 patients with bone-only metastases. Association between bone-only relapse and clinico-pathological risk factors was assessed in multivariate models using the tree-building algorithms “exhausted CHAID (Chi-square Automatic Interaction Detectors)” and CART(Classification and Regression Tree), as well as radial basis function networks (RBF-net), feedforward multilayer perceptron networks (MLP) and logistic regression.ResultsMultivariate analysis demonstrated that breast cancer subtypes have the strongest influence on the development of bone-only metastases (χ2 = 28). 29.9 % of patients with luminal A or luminal B (ABC-patients) and 11.4 % with triple negative BC (TNBC) or HER2-overexpressing tumours had bone-only metastases (p < 0.001). Five different mathematical models confirmed this correlation. The second important risk factor is the age at primary diagnosis. Moreover, BC subcategories influence the overall survival from date of metastatic disease of patients with bone-only metastases. Patients with bone-only metastases and TNBC (p < 0.001; HR = 7.47 (95 % CI: 3.52–15.87) or HER2 overexpressing BC (p = 0.007; HR = 3.04 (95 % CI: 1.36–6.80) have the worst outcome compared to patients with luminal A or luminal B tumours and bone-only metastases.ConclusionThe bottom line of different mathematical models is the prior importance of subcategories of breast cancer and the age at primary diagnosis for the appearance of osseous metastases. The primary tumour stage, histological subtype, tumour size, the number of affected lymph nodes, grading and NPI seem to have only a minor influence on the development of bone-only metastases.

【 授权许可】

CC BY   
© Diessner et al. 2016