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Survival outcomes of breast cancer patients with brain metastases: A multicenter retrospective study in Korea (KROG 16-12)

Title
Survival outcomes of breast cancer patients with brain metastases: A multicenter retrospective study in Korea (KROG 16-12)
Authors
Kim, Jae SikKim, KyuboJung, WonguenShin, Kyung HwanIm, Seock-AhKim, Hee-JunKim, Yong BaeChang, Jee SukChoi, Doo HoPark, Yeon HeeKim, Dae YongKim, Tae HyunChoi, Byung OckLee, Sea-WonKim, SuzyKwon, JeannyKang, Ki MunChung, Woong-KiKim, Kyung SuNam, Ji HoYoon, Won SupKim, Jin HeeCha, JihyeOh, Yoon KyeongKim, In Ah
Ewha Authors
김규보김경수
SCOPUS Author ID
김규보scopus
Issue Date
2020
Journal Title
BREAST
ISSN
0960-9776JCR Link

1532-3080JCR Link
Citation
BREAST vol. 49, pp. 41 - 47
Keywords
Breast cancerBrain metastasisOverall survivalPrognostic modelWhole brain radiotherapy
Publisher
CHURCHILL LIVINGSTONE
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Purpose: This study evaluated the influence of prognostic factors and whole brain radiotherapy (WBRT) on overall survival (OS) of breast cancer (BC) patients with brain metastases (BM). Methods and materials: Medical records of 730 BC patients diagnosed with BM from 2000 to 2014 at 17 institutions were retrospectively reviewed. OS was calculated from BM diagnosis. Median follow-up duration was 11.9 months (range, 0.1-126.2). Results: Median OS was 15.0 months (95% CI: 14.0-16.9). Patients with different BC-specific graded prognostic assessment (GPA) scores showed significant differences (p < 0.001) in OS. In multivariate analysis, histologic grade 3 (p = 0.014), presence of extracranial metastasis (p <0.001), the number of BM (>4; p = 0.002), hormone receptor negativity (p = 0.005), HER2-negativity (p = 0.003), and shorter time interval (<30 months) between BC and BM diagnosis (p = 0.007) were associated with inferior OS. By summing the beta-coefficients of variables that were prognostic in multivariate analyses, we developed a prognostic model that stratified patients into low-risk (<= 0.673) and high-risk (>0.673) subgroups; the high-risk subgroup had poorer median OS (10.1 months, 95% CI: 7.9-11.9 vs. 21.9 months, 95% CI: 19.5 -27.1, p <0.001). Univariate and multivariate analyses of propensity score-matched patients diagnosed with BM >= 30 months after BC diagnosis (n = 389, "late BM") revealed that WBRT-treated patients showed superior OS compared to non-WBRT-treated patients (p = 0.070 and 0.030, respectively). Conclusion: Our prognostic model identified high-risk BC patients with BM who might benefit from increased surveillance; if validated, our model could guide treatment selection for such patients. Patients with late BM might benefit from WBRT as initial local treatment. (C) 2019 Elsevier Ltd.
DOI
10.1016/j.breast.2019.10.007
Appears in Collections:
의과대학 > 의학과 > Journal papers
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