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Maajani K, Jalali A, Alipour S, Khodadost M, Tohidinik HR, Yazdani K. The Global and Regional Survival Rate of Women With Breast Cancer: A Systematic Review and Meta-analysis. Clin Breast Cancer 2019; 19:165-177. [PMID: 30952546 DOI: 10.1016/j.clbc.2019.01.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/10/2019] [Accepted: 01/19/2019] [Indexed: 12/22/2022]
Abstract
Breast cancer is the most common cancer among women in the world. The aim of this study was to measure the global and regional survival rates of women with breast cancer. We searched Medline/PubMed, Web of Science, Scopus, and Google Scholar to identify cohort studies on the survival rate of women with primary invasive breast cancer until the end of June 2017. We used random effect models to estimate the pooled 1-, 3-, 5-, and 10-year survival rates. Subgroup analysis and meta-regression models were used to investigate the potential sources of heterogeneity. One hundred twenty-six studies were included in the meta-analysis. Between-study heterogeneities in the 1-, 3-, 5-, and 10-year survival rates were significantly high (all I2s > 50%; P = .001). The global 1-, 3-, 5-, and 10-year pooled survival rates in women with breast cancer were 0.92 (95% confidence interval [CI], 0.90-0.94), 0.75 (95% CI, 0.71-0.79), 0.73 (95% CI, 0.71-0.75), and 0.61% (95% CI, 0.54-0.67), respectively. Subgroup analysis revealed that survival rates varied in different World Health Organization regions, age and stage at diagnosis, year of the studies, and degree of development of countries. Meta-regression indicated that year of the study (β = 0.07; P = .002) and development of country (β = -0.1; P = .0001) were potential sources of heterogeneity. The survival rate was improved in recent decades; however, it is lower in developing regions than developed ones.
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Affiliation(s)
- Khadije Maajani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf Alipour
- Breast Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Khodadost
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Gerash University of Medical Sciences, Gerash, Iran
| | - Hamid Reza Tohidinik
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kamran Yazdani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Chronologically changing patterns in the survival of korean patients with breast cancer and related clinical factors: a nationwide registry-based study. Breast Cancer Res Treat 2018; 172:273-282. [PMID: 30088179 DOI: 10.1007/s10549-018-4892-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Advances in breast cancer treatment have contributed to marked improvements in patient outcomes over the past three decades. This study aims to chronologically evaluate the survival of patients with breast cancer and investigate the observed changes over time. METHODS Statistics from the Korean National Cancer Registry, based on all 60,571 patients with invasive breast cancer during the 21 year period, were analyzed. We divided the study interval into four periods (P1: 1988-1992, P2: 1993-1997, P3: 1998-2002, P4: 2003-2008). RESULTS The patients treated during P4 showed significantly better 5-year overall survival (OS) than did those treated during P1 (5Y OS; P1 = 79.0 vs. P4 = 92.2, p < 0.001). In the multivariate analyses, younger age, mastectomy, high stage, high tumor grade, lymphovascular invasion, and hormone receptor negativity were poor prognostic factors. The multivariate analysis demonstrated that diagnosis periods significantly and independently associated with OS in the overall group of patients. In our analysis of age-period-interaction models, the hazard ratio (HR) for death for patients who were under 35 years of age, compared to those who were older, tended to decrease over time (HR of age < 35 vs. 35 ~ 50; P1 = 0.739, p = 0.007; P2 = 0.744, p < 0.001; P3 = 0.886, p = 0.041; P4 = 0.983, p = 0.813). The survival rate of patients who underwent breast conserving surgery (BCS) has recently gotten better than that of mastectomy (HR of mastectomy vs. BCS; P1 = 0.957, p = 0.790; P2 = 0.542, p < 0.001; P3 = 0.543, p < 0.001; P4 = 0.425, p < 0.001). CONCLUSIONS The clinical factors related to the changes in breast cancer survival have improved and increased patient OS over the past 20 years in Korea. In addition, we provided new insights into the effects of age and surgery methods on prognosis in each period.
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Kiba T, Morii N, Takahashi H, Ozaki S, Atsumi M, Masumoto F, Shitakubo Y, Yamashiro H. Examination of the clinical efficacy of eribulin and trastuzumab in HER2-positive recurrent breast cancer. Mol Clin Oncol 2015; 4:47-50. [PMID: 26870356 DOI: 10.3892/mco.2015.668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 10/26/2015] [Indexed: 11/05/2022] Open
Abstract
There are limited studies reported that describe the efficacy of eribulin and trastuzumab in the treatment of recurrent breast cancer. The present study examined the therapeutic efficacy of eribulin and trastuzumab in the treatment of recurrent breast cancer. Between October 2011 and August 2013, 5 recurrent breast cancer patients who were treated with eribulin and trastuzumab were included in the study. The cancer stages in the 5 women who received this regimen were stage IIIB in 1 (20%) and stage IV in 4 (80%). The sites of recurrence were the lung in 3 patients, liver in 2, bone in 1, brain in 1, supraclavicular lymph nodes in 1, infraclavicular lymph nodes in 1 and mediastinal lymph nodes in 1. The median number of prior treatment regimens was 5 (range, 5-11). Complete response was achieved in 0 patients, 1 achieved partial response, 3 had stable disease, and 1 had progressive disease. The overall response rate was 20%, and the clinical benefit rate was 80%. Patients also reported grade 3/4 neutropenia (80.0%). However, hematological toxicity was reversible and manageable. The most common grade 3/4 nonhematological toxicities were fatigue (20.0%), peripheral neuropathy (20.0%) and appetite loss (20.0%). No patients withdrew from treatment, and favorable compliance was achieved in the study. The results indicated that eribulin and trastuzumab have the potential to be one of the drugs for treatment of recurrent breast cancer.
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Affiliation(s)
- Takayoshi Kiba
- Division of Modern Medical Technology, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan
| | - Nao Morii
- Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan; Department of Breast Surgery, Tenri Hospital, Tenri, Nara 632-8552, Japan
| | - Hirotoshi Takahashi
- Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan
| | - Shinji Ozaki
- Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan
| | - Misao Atsumi
- Clinical Trial Management Office, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan
| | - Fumi Masumoto
- Clinical Trial Management Office, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan
| | - Yoshimi Shitakubo
- Division of Modern Medical Technology, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan
| | - Hiroyasu Yamashiro
- Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan; Department of Breast Surgery, Tenri Hospital, Tenri, Nara 632-8552, Japan
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Zeichner SB, Ambros T, Zaravinos J, Montero AJ, Mahtani RL, Ahn ER, Mani A, Markward NJ, Vogel CL. Defining the survival benchmark for breast cancer patients with systemic relapse. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2015; 9:9-17. [PMID: 25922577 PMCID: PMC4401244 DOI: 10.4137/bcbcr.s23794] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 02/10/2015] [Accepted: 02/12/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable. METHODS Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between 1996 and 2006 after primary treatment. There were 189 patients diagnosed with metastatic disease within 2 months of being seen by our therapeutic team and 101 patients diagnosed with metastatic disease greater than 2 months. The patients were divided in order to account for lead-time bias than could potentially confound the analysis of the latter 101 patients. RESULTS Median survival for our primary study population of 189 patients was 33 months. As expected, the median survival from first systemic relapse (MSFSR) for the 101 patients excluded because of the potential for lead-time bias was better at 46 months. Factors influencing prognosis included estrogen receptor (ER) status, disease-free interval (DFI), and dominant site of metastasis. Compared with our original series, even with elimination of local-regional recurrences in our present series, the median survival from first relapse has improved by 7 months over the past two decades. CONCLUSION The new benchmark for MSFSR approaches 3 years.
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Affiliation(s)
- Simon B Zeichner
- Department of Hematology and Oncology, Emory Winship Cancer Institute, Atlanta, GA, USA
| | - Tadeu Ambros
- Department of Hematology and Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - John Zaravinos
- Department of Medicine, SUNY Downstate Medical Center, New York, NY, USA
| | - Alberto J Montero
- Department of Solid Tumor Oncology, Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH, USA
| | - Reshma L Mahtani
- Department of Hematology and Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Boca Raton, FL, USA
| | - Eugene R Ahn
- Cancer Treatment Centers of America at Midwestern Regional Medical Center, Zion, IL, USA
| | - Aruna Mani
- Memorial Breast Cancer Center, Memorial Healthcare System, Pembroke Pines, FL, USA
| | | | - Charles L Vogel
- Department of Hematology and Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Boca Raton, FL, USA
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Tsuji W, Teramukai S, Ueno M, Toi M, Inamoto T. Prognostic factors for survival after first recurrence in breast cancer: a retrospective analysis of 252 recurrent cases at a single institution. Breast Cancer 2012; 21:86-95. [DOI: 10.1007/s12282-012-0358-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 03/07/2012] [Indexed: 10/28/2022]
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Nakajo M, Kajiya Y, Kaneko T, Kaneko Y, Takasaki T, Tani A, Ueno M, Koriyama C, Nakajo M. FDG PET/CT and diffusion-weighted imaging for breast cancer: prognostic value of maximum standardized uptake values and apparent diffusion coefficient values of the primary lesion. Eur J Nucl Med Mol Imaging 2010; 37:2011-20. [DOI: 10.1007/s00259-010-1529-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 06/14/2010] [Indexed: 11/28/2022]
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Ishida T, Kiba T, Takeda M, Matsuyama K, Teramukai S, Ishiwata R, Masuda N, Takatsuka Y, Noguchi S, Ishioka C, Fukushima M, Ohuchi N. Phase II study of capecitabine and trastuzumab combination chemotherapy in patients with HER2 overexpressing metastatic breast cancers resistant to both anthracyclines and taxanes. Cancer Chemother Pharmacol 2009; 64:361-9. [PMID: 19082596 PMCID: PMC2688618 DOI: 10.1007/s00280-008-0882-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 11/11/2008] [Accepted: 11/20/2008] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to investigate the activity of capecitabine and trastuzumab in patients with HER2-overexpressing metastatic breast cancer resistant to both anthracyclines and taxanes. METHOD From June 2003 and May 2006, 40 female patients with measurable or assessable metastatic breast cancer were enrolled and data from 38 patients were reviewed extramurally and analyzed. Patients were treated with weekly trastuzumab given at a dose of 2 mg/kg/day over 90 min (4 mg/kg/day on the first infusion) and capecitabine given at a dose 1,657 mg/m(2)/day during 21 days with a subsequent pause of 7 days. This cycle was repeated every 28 days. The primary endpoint was overall survival and secondary endpoints were progression-free survival and response rate. RESULT A median of 4.5 cycles (range 1-9 cycles) were delivered. The median age was 53 (range 30-69 years). Median overall survival and progression-free survival was 22.3 and 4.1 months, respectively. Survival rate at 1 and 2 year was 81.6 and 47.4%, respectively. Response rate was 18.4% (95% CI, 7.7-34.3%). All evaluable patients have responded with two CR (5.3%), 5 PR (13.2%), 20 SD (52.6%), 8 PD (21.1%) and 3 NE (7.9%). Regarding the hematological toxicities, grade 1/2/3 neutropenia, grade 1/2 anemia, grade 1 thrombocytopenia and grade 1/2 liver dysfunction were also common. No treatment-related death was reported. CONCLUSION The combination of capecitabine and trastuzumab is active and well-tolerated in patients with HER2-overexpressing breast caner resistant to both anthracyclines and taxanes.
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MESH Headings
- Adult
- Aged
- Anthracyclines/administration & dosage
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Humanized
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/metabolism
- Capecitabine
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/metabolism
- Deoxycytidine/administration & dosage
- Deoxycytidine/analogs & derivatives
- Drug Resistance, Neoplasm
- Female
- Fluorouracil/administration & dosage
- Fluorouracil/analogs & derivatives
- Humans
- Immunoenzyme Techniques
- Lymphatic Metastasis
- Male
- Maximum Tolerated Dose
- Middle Aged
- Neoplasm Staging
- Prognosis
- Receptor, ErbB-2/genetics
- Receptor, ErbB-2/metabolism
- Salvage Therapy
- Survival Rate
- Taxoids/administration & dosage
- Trastuzumab
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Takanori Ishida
- Department of Surgical Oncology, Tohoku University School of Medicine, 1–1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | | | - Motohiro Takeda
- Department of Surgical Oncology, Tohoku University School of Medicine, 1–1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Kotone Matsuyama
- Translational Research Informatics Center, Kobe, Japan
- Department of Clinical Trial Design and Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Teramukai
- Translational Research Informatics Center, Kobe, Japan
- Department of Clinical Trial Design and Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Norikazu Masuda
- Department of Surgery, Osaka National Hospital, Osaka, Japan
| | | | - Shinzaburo Noguchi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute of Developing, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Masanori Fukushima
- Translational Research Informatics Center, Kobe, Japan
- Department of Clinical Trial Design and Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ohuchi
- Department of Surgical Oncology, Tohoku University School of Medicine, 1–1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
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Risk reduction of distant metastasis in hormone-sensitive postmenopausal breast cancer. Breast Cancer 2009; 16:207-18. [DOI: 10.1007/s12282-009-0096-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 01/09/2009] [Indexed: 10/21/2022]
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Kiba T, Inamoto T, Nishimura T, Ueno M, Yanagihara K, Teramukai S, Kato H, Toi M, Fukushima M. The reversal of recurrence hazard rate between ER positive and negative breast cancer patients with axillary lymph node dissection (pathological stage I-III) 3 years after surgery. BMC Cancer 2008; 8:323. [PMID: 18990247 PMCID: PMC2585098 DOI: 10.1186/1471-2407-8-323] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 11/07/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prognostic factors are defined as biological or clinical measurement associated with overall survival and/or disease-free survival. Previous studies have shown that patients with estrogen receptor (ER) positive cancers have a better prognosis than patients whose cancers do not have these receptors. METHODS This study investigated the assessment of variables in defining prognosis of 742 breast cancer women with pathological stage (pTNM) I-III diagnosed between 1980 and 2005 at the Kyoto University Hospital in Japan, by age, clinical stage (cTNM), pTNM, the numbers of positive lymph nodes (pN), and ER status. RESULTS Multivariate analysis demonstrated that pTNM and ER status were the independent prognostic factors for overall survival, and that pTNM and pN were the independent prognostic factors for disease-free survival. For the 0- to 2-year interval, the hazard of recurrence was higher for the ER-negative patients than the ER-positive patients, and beyond 3 years the hazard was higher for ER-positive patients. CONCLUSION The present study confirmed the previous reports which showed favorable prognosis of the patients with lesser pTNM or positive ER status. A reversal of recurrence hazard rate between ER positive and negative breast cancer patients beyond 3 years after operation was detected. The fact may indicate the importance of long term adjuvant hormone therapy for ER positive cancer patients.
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Affiliation(s)
- Takayoshi Kiba
- Outpatient Oncology Unit, Kyoto University Hospital, Kyoto, Japan.
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