Clinical characteristics and prognosis of triple-negative breast cancer patients with postoperative initial visceral metastasis / 肿瘤

ABSTRACT

Objective: To analyze and discuss the clinicopathologic characteristics of triple-negative breast cancer with initial visceral metastasis after surgery, as well as the efficacy of first-line chemotherapy and the prognostic factors. Methods: A retrospective analysis was performed using the clinical data of 107 triple-negative breast cancer patients with postoperative initial visceral metastasis, who were treated in Department of Medical Oncology, Fudan University Shanghai Cancer Center from January 1, 2011 to June 30, 2013. The analysis also included their first-line chemotherapy efficacy, survival situation and prognostic factors. Results: Among 107 patients, there were 101 patients (94.4%) with invasive ductal carcinoma and 6 patients (5.6%) with other pathological types or mixed patterns. The postoperative median disease-free interval was 14.4 months; the 1-, 2- and 3-year survival rates after visceral metastasis were 75.7%, 41.1% and 22.4%, respectively. The objective response rate of first-line platinum-based chemotherapy was 60.0%, and the median progressionfree survival time was 8.6 months; which were significantly higher or longer than that in the non-platinum chemotherapy group (36.2%, P = 0.014; 5.1 months, P = 0.023). However, there was no significant difference in the median survival time between the two groups (19.9 vs 20.9 months, P = 0.423). Univariate analysis showed that neoadjuvant chemotherapy, postoperative radiotherapy, lymph node metastasis status, clinical stage, disease-free interval, best curative effect of first-line chemotherapy, plurivisceral metastasis, and progression-free survival after first-line chemotherapy had significant effects on the overall survival (all P < 0.05). Additionally, multivariate analysis showed that neoadjuvant chemotherapy and disease-free interval had significant effects on overall survival (both P < 0.05). Conclusion: The triple-negative breast cancer patients with initial visceral metastasis have short disease-free interval time and low long-term survival rate. The first-line platinumbased chemotherapy is a good choice for these patients. The neoadjuvant chemotherapy and disease-free interval within one year may be the independent prognostic factors for their overall survival.