BACKGROUND: We aim to examine the characteristics and survival of patients with de novo metastatic breast cancer (dnMBC) and recurrent metastatic breast cancer (rMBC) in New Zealand.
METHODS: This study included women diagnosed with dnMBC and women who developed rMBC between 2010 and 2017. The Kaplan-Meier method was used to examine cancer-specific survival. Cox proportional hazards regression was used to estimate the adjusted hazard ratio (HR) of cancer-specific mortality by ethnicity, age, year of diagnosis, socioeconomic deprivation, site of metastases, number of metastatic sites, biomarker subtype and MBC subgroup.
RESULTS: We included 2177 MBC patients (667 dnMBC and 1510 rMBC). The median survival of dn MBC patients was 26 months compared to 18 months for rMBC. There were no differences in breast-cancer specific mortality by ethnicity or socioeconomic deprivation. The adjusted HR for patients with visceral metastases compared to patients with non-visceral metastases was 1.41, and the adjusted HR for triple negative disease compared to Luminal A disease was 2.24. Compared to dnMBC, the adjusted HRs for rMBC patients with a metastatic-free interval of < 2 years, 2-4 years, 5-7 year and 8 + years were 1.81, 1.47, 1.08 and 0.82, respectively.
CONCLUSIONS: The survival for patients with MBC in New Zealand is very similar to other developed countries. Patients with dnMBC had a much better prognosis than those with recurrent disease. Patients with triple negative disease or non-luminal HER2 positive disease had the worst prognosis. The prognosis for patient with rMBC improved the longer the time from diagnosis to the development of metastases.

BACKGROUND: Limited data exist on the impact of the site of metastases on survival in patients with stage IV prostate cancer (PCa).
OBJECTIVE: To investigate the role of metastatic phenotype at presentation on mortality in stage IV PCa.
METHODS: Overall, 3857 patients presenting with metastatic PCa between 1991 and 2009, included in the Surveillance Epidemiology and End Results-Medicare database were evaluated.
UNASSIGNED: Overall and cancer-specific survival rates were estimated in the overall population and after stratifying patients according to the metastatic site (lymph node [LN] alone, bone, visceral, or bone plus visceral). Multivariable Cox regression analyses tested the relationship between the site of metastases and survival. All analyses were repeated in a subcohort of patients with a single metastatic site involved.
CONCLUSIONS: Respectively, 2.8%, 80.2%, 6.1%, and 10.9% of patients presented with LN, bone, visceral, and bone plus visceral metastases at diagnosis. Respective median overall survival and cancer-specific survival were 43 mo and 61 mo for LN metastases, 24 mo and 32 mo for bone metastases, 16 mo and 26 mo for visceral metastases, and 14 mo and 19 mo for bone plus visceral metastases (p<0.001). In multivariable analyses, patients with visceral metastases had a significantly higher risk of overall and cancer-specific mortality versus those with exclusively LN metastases (p<0.001). The unfavorable impact of visceral metastases persisted in the oligometastatic subgroup. Our study is limited by its retrospective design.
CONCLUSIONS: Visceral involvement represents a negative prognostic factor and should be considered as a proxy of more aggressive disease in patients presenting with metastatic PCa. This parameter might indicate the need for additional systemic therapies in these individuals.
RESULTS: Patients with visceral metastases should be considered as affected by more aggressive disease and might benefit from the inclusion in clinical trials evaluating novel molecules.