Abstract
Women with recurrent metastatic breast cancer from a Spanish hospital registry (El Alamo, GEICAM) were analyzed in order to identify the most helpful prognostic factors to predict survival and to ultimately construct a practical prognostic index. The inclusion criteria covered women patients diagnosed with operable invasive breast cancer who had metastatic recurrence between 1990 and 1997 in GEICAM hospitals. Patients with stage IV breast cancer at initial diagnosis or with isolated loco-regional recurrence were excluded from this analysis. Data from 2,322 patients with recurrent breast cancer after primary treatment (surgery, radiation and systemic adjuvant treatment) were used to construct the prognostic index. The prognostic index score for each individual patient was calculated by totalling up the scores of each independent variable. The maximum score obtainable was 26.1. Nine-hundred and sixty-two patients who had complete data for all the variables were used in the computation of the prognostic index score. We were able to stratify them into three prognostic groups based on the prognostic index score: 322 patients in the good risk group (score ≤13.5), 308 patients in the intermediate risk group (score 13.51–15.60) and 332 patients in the poor risk group (score ≥15.61). The median survivals for these groups were 3.69, 2.27 and 1.02 years, respectively (P < 0.0001). In conclusion, risk scores are extraordinarily valuable tools, highly recommendable in the clinical practice.
References
Jemal A, Siegel R, Ward E et al (2008) Cancer statistics 2008. CA Cancer J Clin 58:71–96
López-Abente G, Pollán M, Aragonés N et al (2003) Plan Integral del Cáncer: Situación del Cáncer en España. Ministerio de Sanidad y Consumo, Madrid
Hortobagyi GN (1998) Treatment of breast cancer. N Engl J Med 339:974–984
Greenberg PA, Hortobagyi GN, Smith TL et al (1996) Long-term follow-up of patients with complete remission following combination chemotherapy for metastatic breast cancer. J Clin Oncol 14:2197–2205
Surveillance, Epidemiology, and End Results (SEER) Database. Available at: http://www.seer.cancer.gov/statfacts/htlm/breast.htlm
Hudis CA (2003) Current status and future directions in breast cancer therapy. Clin Breast Cancer 4:S70–S75
Carter CL, Allen C, Henson DE (1989) Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer 63:181–187
De la Haba-Rodríguez J, Aranda E, Llombart A et al (2008) Time-to-progression in breast cancer: a stratification model for clinical trials. Breast 17(3):239–244
Insa A, Lluch A, Prosper F et al (1999) Prognostic factors predicting survival from first recurrence in patients with metastatic breast cancer: analysis of 439 patients. Breast Cancer Res Treat 56:67–78
Martín M, Mahillo E, Llombart-Cussac A et al (2006) The “El Álamo” project (1990–1997): two consecutives hospital-based studies of breast cancer outcomes in Spain. Clin Transl Oncol 8(7):508–518
McShane LM, Altman DG, Sauerbrei W et al (2006) Reporting recommendations for tumor marker prognostic studies (REMARK). Breast Cancer Res Treat 100:229–235
Vogel CL, Azevedo S, Hilsenbeck S et al (1992) Survival after first recurrence of breast cancer. The Miami experience. Cancer 70:129–135
Chang J, Clark G, Allred C et al (2003) Survival of patients with metastatic breast cancer. Importance of prognostic markers of the primary tumor. Cancer 97:545–553
Woodward W, Vinh-Hung V, Ueno N et al (2006) Prognostic value of nodal ratios in node-positive breast cancer. J Clin Oncol 24:1910–1916
James JJ, Evans AJ, Pinder SE et al (2003) Bone metastases from breast carcinoma: histopathological-radiological correlations and prognostic features. Br J Cancer 89:660–665
Atalay G, Biganzoli L, Renard F et al (2002) Clinical outcome of breast cancer patients with liver metastases in the anthracycline-taxane era. Breast Cancer Res Treat 76:S47
Alba E, Ribelles N, Sevilla I et al (2001) Adjuvant anthracycline therapy as a prognostic factor in metastatic breast cancer. Breast Cancer Res Treat 66:33–39
Singletary SE, Walsh G, Vauthey JN et al (2003) A role for curative surgery in the treatment of selected patients with metastatic breast cancer. Oncolgist 8:241–251
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Puente, J., López-Tarruella, S., Ruiz, A. et al. Practical prognostic index for patients with metastatic recurrent breast cancer: retrospective analysis of 2,322 patients from the GEICAM Spanish El Alamo Register. Breast Cancer Res Treat 122, 591–600 (2010). https://doi.org/10.1007/s10549-009-0687-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-009-0687-4