METHODS: We retrospectively reviewed the clinical, histopathological, and molecular-genetic characteristics, treatments, and survival outcomes of MBC diagnosed between 2007 and 2017 in the Czech Republic. Prognostic factors of overall survival (OS), recurrence-free interval (RFi), and breast cancer-specific mortality (BCSM) were analyzed and indirectly compared to international data.
RESULTS: We analyzed 256 patients with MBC (median age 66 years), including 12% with de novo metastatic (M1). Of 201 non-metastatic (M0) patients, 6% were <40 years old, 29% had stage I, 55% were cN0, and 54% underwent genetic testing. Overall, 97% of tumors had estrogen receptor expression ≥10%, 61% had high Ki67 index, 40% were high-grade (G3), and 68% were luminal B-like (HER2-negative). Systemic therapies included endocrine therapy (90%) and chemotherapy (53%). Few (5%) patients discontinued adjuvant endocrine therapy for reasons other than disease relapse or death. Patients treated with aromatase inhibitors alone had significantly shorter RFi (P < .001). OS, RFi, and BCSM were associated with disease stage, T stage, N stage, progesterone receptor expression, grade, and Ki67 index. Median OS reached 122 and 42 months in M0 and de novo M1 patients, respectively.
CONCLUSIONS: Due to the rarity of MBC, this study highlights important findings from real clinical practice. Although the number of patients with MBC with unfavorable features was higher in this Czech dataset than in international studies, the prognosis remains consistent with real-world evidence.
方法:我们回顾性回顾了临床,组织病理学,和分子遗传特征,治疗,和2007年至2017年在捷克共和国诊断的MBC的生存结果。总生存期(OS)的预后因素,无复发间隔(RFI),和乳腺癌特异性死亡率(BCSM)进行分析,并与国际数据进行间接比较.
结果:我们分析了256例MBC患者(中位年龄66岁),包括12%的从头转移(M1)。在201名非转移性(M0)患者中,6%的人年龄<40岁,29%的人有第一阶段,55%为cN0,54%进行了基因检测。总的来说,97%的肿瘤有雌激素受体表达≥10%,61%的人有高Ki67指数,40%为高档(G3),68%为管腔B样(HER2阴性)。全身治疗包括内分泌治疗(90%)和化疗(53%)。很少(5%)患者因疾病复发或死亡以外的原因停止辅助内分泌治疗。单独使用芳香化酶抑制剂治疗的患者的RFI明显缩短(P<.001)。操作系统,RFI,BCSM与疾病分期有关,T级,N级,孕激素受体表达,grade,Ki67指数。M0和从头M1患者的中位OS达到122和42个月,分别。
结论:由于MBC的稀有性,这项研究突出了来自实际临床实践的重要发现.尽管在这个捷克数据集中,具有不利特征的MBC患者数量高于国际研究,预后与现实证据一致.