Incidence and prognostic factors of Japanese breast cancer patients with bone metastasis |
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Authors: | Hiroyuki Oka Taiji Kondoh Atsushi Seichi Takahiro Hozumi Kozo Nakamura |
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Institution: | (1) Department of Orthopaedic Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan;(2) Department of Orthopaedic Surgery, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan |
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Abstract: | Background Few previous studies have analyzed the incidence of bone metastases in a defined population of Japanese breast cancer patients
and their prognosis after chemotherapy.
Methods This is a retrospective cohort study. We investigated 695 patients who underwent surgery for breast cancer. The strategy of
adjuvant therapy was as follows. Patients with both estrogen receptors (ERs) and progesterone receptors (PgRs) had endocrine
therapy as initial adjuvant therapy (n = 239). Patients with neither ERs nor PgRs had chemotherapy. When metastasis to other organs, including bone, was identified,
patients received chemotherapy. The survival rates after surgery and after the onset of bone metastasis, as well as the incidence
of bone metastasis, were calculated. We also evaluated the prognostic and predictive factors.
Results Bone metastases developed in 148 of 695 patients. All 148 received chemotherapy, and 121 of them developed spinal metastases.
The 5-year survival rate after bone metastases was 26.1%. Prognostic factors for bone metastases were visceral metastases
and PgR status. Cord compression was observed in 17 of the 148 patients, with the thoracic spine being the most common. The
1-year survival rate for patients with bone metastases who received chemotherapy was 66.3%, whereas that of patients with
paralysis after spinal metastases was 17.6%. Within 6 months of the development of spinal cord compression, 70.6% of the patients
died.
Conclusions We reported the incidence and prognostic factors for a defined population of Japanese breast cancer patients with bone and
spinal metastases. Our results suggest that the expected survival time for patients with paralysis who received adequate endocrine
therapy or chemotherapy is generally poor. However, to detect a predictive factor of long survival after paralysis and establish
the indications for surgery, a comparative study among large groups of patients with paralysis and with different backgrounds
is necessary. |
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