Improvement of Survival in Patient with Primary Metastatic Breast Cancer over a 10-Year Periode: Prospective Analyses Based on Individual Patient Date from a Multicenter Data Bank

Abstract


Approximately 6% of patients with breast cancer have distant metastases at the time of the initial diagnosis. The aim of this analysis was to examine the overall survival rate over time and to investigate the effect of new therapy options. Methods: This retrospective analysis was performed based on the data bank of the Clinic for Gynaecological Oncology/Dr. Horst Schmidt Klinik, Wiesbaden and the Clinic for Gynaecological Oncology and Senology/Kliniken Essen Mitte, Essen. The patients with primary metastatic breast cancer (pmBC) who were diagnosed and treated at the accredited breast cancer centres of these clinics were enrolled between 1998 and 2007. The date of diagnosis was used to define 2 specifically chosen 5-year periods: 1998-2002 and 2003-2007. The follow-up time was on average 76 months. The Breslow Test was used to evaluate changes in the median survival time and to detect factors associated with the increase in survival rates. Results: Two hundred sixteen patients with complete baselines were analysed. Ninety patients were diagnosed between 1998 and 2002, and 126 patients received their diagnosis of pmBC between 2003 and 2007. The tumour-biological factors were the same in both groups, whereas the therapeutic concepts were different—the later group (2003-2007) received more aromatase inhibitors, taxane-based chemotherapy and trastuzumab. This finding resulted in an increased median survival time from 31 months in the years 1998-2002 to 44 months in the group with the first diagnosis between 2003 and 2007. Conclusions: Primary metastatic breast cancer occurred at constant rates over last 10 years. The tumour findings did not change in the time between the two examined groups; however, the treatment options in the 2003-2007 group included newly approved therapies. The time period of the first diagnosis was detected as a risk factor for overall survival. Those patients diagnosed in the more recent time frame had a significantly improved survival rate. The establishment of new therapy options may explain this finding.

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J. Barinoff, F. Heitz, S. Kuemmel, C. Dittmer, R. Hils, F. Lorenz-Salehi, A. Traut and A. Bois, "Improvement of Survival in Patient with Primary Metastatic Breast Cancer over a 10-Year Periode: Prospective Analyses Based on Individual Patient Date from a Multicenter Data Bank," Journal of Cancer Therapy, Vol. 4 No. 8, 2013, pp. 1306-1312. doi: 10.4236/jct.2013.48154.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Robert Koch Institut, “Krebs in Deutschland 2007/2008. H?ufigkeit und Trends,” 8th Revised Edition, RobertKoch-Institut und Gesellschaft für Epidemiologische Krebsregister in Deutschland e.V., Robert Koch Institut, Berlin, 2012. www.rki.de/krebs
[2] Robert Koch Institute and Association of PopulationBased Cancer Registries in Germany, “Cancer in Germany 2005/2006. Incidence and Trends,” 17th Edition, Robert Koch Institute and Association of PopulationBased Cancer Registries in Germany, Berlin, 2010.
[3] C. Smigal, A. Jemal, E. Ward, et al., “Trends in Breast Cancer by Race and Ethnicity: Update 2006,” CA: A Cancer Journal for Clinicians, Vol. 56, No. 3, 2006, pp. 168-183. http://dx.doi.org/10.3322/ canjclin.56.3.168
[4] A. M. Brewster, G. N. Hortobagi, K. R. Brogilo, et al., “Residual Risk of Breast Cancer Recurrence 5 Years after Adjuvant Therapy,” Journal of the National Cancer Institute, Vol. 100, No. 16, 2008, pp. 1179-1183. http://dx.doi.org/10.1093/jnci/djn233
[5] D. Schon, J. Bertz, B. Gorsch, et al., “Die Dachdokumentation Krebs,” Gesundheitsbl-Gesundheitsforsch-Gesundheitsschutz, Vol. 47, No. 5, 2004, pp. 429-436. http://dx.doi.org/10.1007/ s00103-004-0830-7
[6] L. A. G. Ries and M. P. Eisner, “Cancer of the Female Breast,” In: L. A. G. Ries, G. E. Keel, M. P. Eisner, et al., Eds., SEER Survival Monograph: Cancer Survival among Adults, US SEER Program, 1988-2001, Patient and Tumor Characteristics, National Cancer Institute, NIH Publication, Bethesda, 2007, pp. 101-110.
[7] G. M. Clark, G. W. Sledge Jr., C. K. Obsorneand W. L. McGuire, “Survival from First Recurrence: Relative Importance of Prognostic Factors in 1015 Breast Cancer Patient,” Journal of Clinical Oncology, Vol. 5, No. 1, 1987, pp. 55-61.
[8] D. Schon, J. Bertz, B. Gorsch, et al., “Entwicklung der überlebensraten von Krebspatienten in Deutschland. Gesundheitsberichterstattung für Deutschland,” Robert Koch-Institut, Berlin, 1999.
[9] J. W. Hrsg, “Manual Mammakarzinome: Empfehlung zur Diagnostik, Therapie und Nachsorge,” W. Zuckschwerdt Verlag, München, 2007.
[10] J. R. Harris, M. Morrow and G. Bonnadona, “Cancer of the Breast,” In: V. T. De Vita Jr., S. Hellman, S. A. Rosenberg, et al., Eds., Cancer: Principles and Practice in Oncology, 4th Edition, JB Lippincott, Philadelphia, 1993, pp. 1264-1332.
[11] F. Andre, K. Slimane, et al., “Breast Cancer with Synchronous Metastases: Trends in Survival during a 14-Year Period,” Journal of Clinical Oncology, Vol. 22, No. 16, 2004, pp. 3302-3308.
http://dx.doi.org/10.1200/JCO.2004.08.095
[12] U. Dafni, I. Grimani, A. Xyrafas, A. G. Eleftheraki and G. Fountzilas, “Fifteen-Year Trends in Metastatic Breast Cancer Survival in Greece,” Breast Cancer Research and Treatment, Vol. 119, No. 3, 2010, pp. 621-631. http://dx.doi.org/10.1007/s10549-009-0630-8
[13] J. Gnerlich, D. B. Jeffe, A. D. Deshpande, J. C. Beers, C. Zander and J. A. Margenthaler, “Surgical Removal of the Primary Tumor Increases Overal Survival in üatients with Metastatic Breast Cacner: Analysis of the 1998-2003 SEER Data,” Annals of Surgical Oncology, Vol. 14, No. 8, 2007, pp. 2187-2194. http://dx.doi.org/10.1245/s10434-007-9438-0
[14] R. E. Mansel, O. Fodstad and W. E. Jiang, “Metastasis of Breast Cancer,” Cancer Metastasis—Biology and Treatment, Vol. 11, Springer, 2007, 435 p. http://dx.doi.org/10.1007/978-1-4020-5867-7
[15] A. Gennari, C. Pier-Franco, R. Rosso, C. Orlandini and P. Bruzzi, “Survival of Metastatic Breast Carcinoma Patients over a 20-Year Period. A Retrospective Analysis Based on Individual Patient Date from Six Consecutive Studies,” Cancer, Vol. 104, No. 8, 2005, pp. 1742-1750. http://dx.doi.org/ 10.1002/cncr.21359
[16] S. K. Chia, C. H. Speers, Y. Dyachkova, A. Kang, S. Malfair-Taylor, J. Barnett, I. A. Coldman, et al., “The Impact of New Chemotherapeutic and Hormone Agents on Survival in Population-Based Cohort of Women with Metastatic Breast Cancer,” Cancer, Vol. 110, No. 5, 2007, pp. 973-979.
http://dx.doi.org/10.1002/cncr.22867
[17] J. Barinoff, F. Heitz, P. Harter, F. Lorens-Salehi, A. Traut, A. du Bois, “Primar Metastasierendes Mammakarzinom: Gesamtüberleben im Zeitlichen Verlauf,” Senologie, Vol. 6, 2009, pp. 177-194.
[18] R. C. Fields, D. B. Jeffe, K. Trinlaus, et al., “Surgical Resection of the Primary Tumor Is Associated with Increased Long-Term Survival in Patients with Stage IV Breast Cancer after Controlling for Site of Metastasis,” Annals of Surgical Oncology, Vol. 14, No. 12, 2007, pp. 3345-3351.
http://dx.doi.org/10.1245/s10434-007-9527-0
[19] J. Ruiterkamp and F. M. Ernst, “The Role of Surgery in Metastatic Breast Cancer,” European Journal of Cancer, Vol. 47, No. Suppl 3, 2011, pp. S6-S22.
[20] F. Petrelli and S. Barni, “Surgery of Primary Tumors in Stage IV Breast Cancer: An Updated Meta-Analysis of Published Studies with Meta-Regression,” Medical Oncology, Vol. 29, No. 5, 2012, pp. 3282-3290.
[21] H. B. Neumann, M. Morrogh, M. Gonen, et al., “Stage IV Breast Cancer in the Era of Targeted Therapy: Does Surgery of the Primary Tumor Matter?” Cancer, Vol. 116, No. 5, 2010, pp. 1226-1233. http://dx.doi.org/10.1002/cncr.24873
[22] L. Cortesi, C. Cirilli, I. Rashid, E. Artioli and M. Federico, “Changes in Survival from Metastatic Breast Cancer during the Last Twenty-Years: A Population Based Study in Northern Italy,” ASCO Annual Meeting, 2009.
[23] Federation of Breast Diseases Societies, “Local Surgery for Metastatic Breast Cancer,” Identifier: NCT00557986, Federation of Breast Diseases Societies, 2012. www.clinicaltrials.gov

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