High comorbidity and tumor proliferation predict survival of localized breast cancer patients after curative surgery: A retrospective analysis of real-world data in Finland
Milla Hollmén , Eliisa Löyttyniemi , Eeva Juhanoja , Pia Vihinen , Maria Sundvall
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引用次数: 0
Abstract
Background
The aim of this study was to analyze the characteristics of breast cancer patients and their impact on real-world treatment and survival outcomes.
Patients and methods
We conducted a retrospective study including all patients newly diagnosed with breast cancer during 2019 in the Southwest Finland. We identified 458 patients diagnosed with either localized (n = 435, 95 %) or metastatic (n = 23, 5 %) breast cancer.
Results
In localized breast cancer, the five-year overall survival (OS) was 90.9 %, while the five-year disease-free survival (DFS) was 93.5 %. In metastatic breast cancer, the five-year progression-free survival (PFS) was 13.0 % and five-year OS 34.2 %. The median PFS was 10.9 months (95 % CI 2.5–19.4 months) and median OS was 30.6 months (lower 95 % CI 6.9 months – not reached).
In the univariate analyses, the most important tumor-specific parameters predicting decreased DFS were tumor proliferation index >20 %, low estrogen receptor expression status and tumor size >2 cm. Univariate predictors for decreased OS included Eastern Cooperative Oncology Group (ECOG) performance status ≥2 and Charlson Comorbidity Index (CCI) score ≥3. In the multivariable analyses, CCI score ≥3 and high proliferation index (21–100 % vs. 0–20 %) predicted poorer DFS, while CCI score ≥3 and increased stage (stage 2 vs. 1) predicted poorer OS. The administration of post-operative radiotherapy was significant in the multivariable analyses of both DFS (HR 4.23, 95 % CI 1.85–9.67, p = 0.0006) and OS (HR 6.84, 95 % CI 3.33–14.02, p < 0.0001).
Conclusion
Our results demonstrate that careful clinical evaluation of ECOG and comorbidities, alongside well-established tumor characteristics predict patient survival in a population where overall five-year survival in breast cancer is over 90 %.
期刊介绍:
Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.