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. 2019 Nov 12;19(1):1091.
doi: 10.1186/s12885-019-6311-z.

The Clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer

Ru Wang  1   2 , Yayun Zhu  2   3 , Xiaoxu Liu  1 , Xiaoqin Liao  1 , Jianjun He  1 , Ligang Niu  4
Affiliations

The Clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer

Ru Wang et al. BMC Cancer. .

Abstract

Background: The features and survival of stage IV breast cancer patients with different metastatic sites are poorly understood. This study aims to examine the clinicopathological features and survival of stage IV breast cancer patients according to different metastatic sites.

Methods: Using the Surveillance, Epidemiology, and End Results database, we restricted our study population to stage IV breast cancer patients diagnosed between 2010 to 2015. The clinicopathological features were examined by chi-square tests. Breast cancer-specific survival (BCSS) and overall survival (OS) were compared among patients with different metastatic sites by the Kaplan-Meier method with log-rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazard model to identify statistically significant prognostic factors.

Results: A total of 18,322 patients were identified for survival analysis. Bone-only metastasis accounted for 39.80% of patients, followed by multiple metastasis (33.07%), lung metastasis (10.94%), liver metastasis (7.34%), other metastasis (7.34%), and brain metastasis (1.51%). The Kaplan-Meier plots showed that patients with bone metastasis had the best survival, while patients with brain metastasis had the worst survival in both BCSS and OS (p < 0.001, for both). Multivariable analyses showed that age, race, marital status, grade, tumor subtype, tumor size, surgery of primary cancer, and a history of radiotherapy or chemotherapy were independent prognostic factors.

Conclusion: Stage IV breast cancer patients have different clinicopathological characteristics and survival outcomes according to different metastatic sites. Patients with bone metastasis have the best prognosis, and brain metastasis is the most aggressive subgroup.

Keywords: Breast cancer; Metastatic sites; SEER; Survival outcomes.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart for patient selection from the Surveillance, Epidemiology and End Results (SEER) database
Fig. 2
Fig. 2
Survival curves with the log-rank tests of overall survival (OS, a, p < 0.001) and breast cancer-specific survival (BCSS, b, p < 0.001) based on metastatic sites for breast cancer patients
Fig. 3
Fig. 3
Survival curves with the log-rank tests of overall survival per metastatic sites according to subtype; HR+/HER2-(a), HR+/HER2 + (b), HR−/HER2 + (c), TN (d). Abbreviations: HR: Hormone receptor, HER2: Human epidermal growth receptor 2, TN: Triple negative
See this image and copyright information in PMC

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