A functional <Emphasis Type="Italic">BRCA1</Emphasis> coding sequence genetic variant contributes to prognosis of triple-negative breast cancer,especially after radiotherapy |
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Authors: | Meng Shi Fei Ma Jibing Liu Huaixin Xing Hui Zhu Jinming Yu Ming Yang |
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Institution: | 1.Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine,The Catholic University of Korea,Seoul,Republic of Korea;2.Cancer Research Institute, College of Medicine,The Catholic University of Korea,Seoul,Republic of Korea;3.Department of Surgery, College of Medicine,Inha University,Incheon,Republic of Korea;4.Department of Surgery, Haeundae-Paik Hospital, College of Medicine,Inje University,Busan,Republic of Korea;5.Division of Breast and Endocrine Surgery, Department of Surgery, University of Ulsan College of Medicine,Asan Medical Center,Seoul,Republic of Korea;6.Department of Surgery,Yeungnam University Hospital,Daegu,Republic of Korea;7.Department of Breast and Thyroid Surgery,Kyungpook National University Medical Center,Daegu,Republic of Korea;8.Department of Breast Surgery, Gil Medical Center,Gachon University,Incheon,Republic of Korea;9.Department of Surgery, Bucheon St. Mary’s Hospital, College of Medicine,The Catholic University of Korea,Bucheon,Republic of Korea |
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Abstract: | PurposeThe prognostic role of primary tumor surgery in women with metastatic breast cancer at diagnosis is contentious. A subset of patients who will benefit from aggressive local treatment is needed to be identified. Using a nationwide database, we developed and validated a predictive model to identify long-term survivors among patients who had undergone primary tumor surgery.MethodsA total of 150,043 patients were enrolled in the Korean Breast Cancer Registry between January 1990 and December 2014. Of these, 2332 (1.6%) presented with distant metastasis at diagnosis. Using Cox proportional hazards regression, we developed and validated a model that predicts survival in patients who undergo primary tumor surgery, based on the clinicopathological features of the primary tumor.ResultsA total of 2232 metastatic breast cancer patients were reviewed. Of these, 1541 (69.0%) patients had undergone primary tumor surgery. The 3-year survival rate was 62.6% in this subgroup. Among these patients, advanced T-stage, high-grade tumor, lymphovascular invasion, negative estrogen receptor status, high Ki-67 expression, and abnormal CA 15-3 and alkaline phosphatase levels were associated with poor survival. A prediction model was developed based on these factors, which successfully identified patients with remarkable survival (score 0–3, 3-year survival rate 87.3%). The clinical significance of the model was also validated with an independent dataset.ConclusionsWe have developed a predictive model to identify long-term survivors among women who undergo primary tumor surgery. This model will provide guidance to patients and physicians when considering surgery as a treatment modality for metastatic breast cancer. |
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