Risk factors of distant metastasis after surgery among different breast cancer subtypes: a hospital-based study in Indonesia

Autor: Wahyu Wulaningsih, Andreas Cahyo Nugroho, Ery Kus Dwianingsih, Teguh Aryandono, Sumadi Lukman Anwar, Wirsma Arif Harahap, Lina Choridah, Widya Surya Avanti
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Oncology
Lung Neoplasms
medicine.medical_treatment
Metastasis
0302 clinical medicine
Breast cancer
Surgical oncology
Risk Factors
Antineoplastic Combined Chemotherapy Protocols
Anthracyclines
030212 general & internal medicine
Breast
Reproductive History
Mastectomy
Subtypes
Age Factors
Bone metastasis
Middle Aged
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Hospitals
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Female
Taxoids
Adult
medicine.medical_specialty
Anthracycline
lcsh:Surgery
Bone Neoplasms
Breast Neoplasms
lcsh:RC254-282
Luminal
Hospital based study
03 medical and health sciences
Internal medicine
medicine
Humans
Neoplasm Staging
Retrospective Studies
Chemotherapy
business.industry
Research
Distant metastasis
lcsh:RD1-811
medicine.disease
Socioeconomic Factors
Indonesia
Surgery
Radiotherapy
Adjuvant
business
Triple negative
Follow-Up Studies
Zdroj: World Journal of Surgical Oncology, Vol 18, Iss 1, Pp 1-16 (2020)
World Journal of Surgical Oncology
ISSN: 1477-7819
DOI: 10.1186/s12957-020-01893-w
Popis: Background More than one third of breast cancer patients including those that are diagnosed in early stages will develop distant metastasis. Patterns of distant metastasis and the associated risks according to the molecular subtypes are not completely revealed particularly in populations of patients with delayed diagnosis and advanced stages. Methods Breast cancer patients (n = 1304) admitted to our institute (2014–2017) were evaluated to identify the metastatic patterns and the associated risks. Metastatic breast cancers at diagnosis were found in 245 patients (18.7%), and 1059 patients were then grouped into non-metastatic and metastatic groups after a median follow-up of 3.8 years. Results Infiltration of the tumor to the skin and chest wall prevailed as the most powerful predictor for distant metastasis (OR 2.115, 95% CI 1.544–2.898) particularly in the luminal A-like subtype (OR 2.685, 95% CI 1.649–4.371). Nodal involvement was also significantly associated with the risk of distant metastasis (OR 1.855, 95% CI 1.319–2.611), and the risk was higher in the Luminal A-like subtype (OR 2.572, 95% CI 1.547–4.278). Luminal A-like subtype had a significant higher risk of bone metastasis (OR 1.601, 95% CI 1.106–2.358). In respect to treatment, a combination of anthracyclines and taxanes-based chemotherapy was significantly associated with lower distant organ spread in comparison with anthracycline-based chemotherapy (OR 0.510, 95% CI 0.355–0.766) and the effect was stronger in Luminal A-like subtype (OR 0.417, 95% CI 0.226–0.769). Classification into Luminal and non-Luminal subtypes revealed significant higher risks of bone metastasis in the Luminal subtype (OR 1.793, 95% CI 1.209–2.660) and pulmonary metastasis in non-Luminal breast cancer (OR 1.445, 95% CI 1.003–2.083). Conclusion In addition to guiding the treatment plan, a comprehensive analysis of clinicopathological variables including the molecular subtypes could assist in the determination of distant metastasis risks of breast cancer patients. Our study offers new perspectives concerning the risks of distant metastasis in breast cancer subtypes in order to plan intensive surveillance or escalation of treatment particularly in a setting where patients are predominantly diagnosed in late stages.
Databáze: OpenAIRE
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