Survival of Stage IV Patients

Survival of breast cancer patients who develop distant metastasis

Background: We aimed to develop a prediction model to identify long-term survivors after developing distant metastasis from breast cancer.

Patients and Methods: From the institution’s database, we collected data of 547 patients who developed distant metastasis during their follow-ups. We developed a model that predicts the post-metastasis overall survival (PMOS) based on the clinicopathologic factors of the primary tumors and the characteristics of the distant metastasis. For validation, the survival data of 254 patients from four independent institutions were used.

Result: The median duration of the PMOS was 31.0 months. The characteristics of the initial primary tumor such as tumor stage, hormone receptor status, and Ki-67 expression level, and the characteristics of the distant metastasis presentation including the duration of disease-free interval, the site of metastasis, and the presence of metastasis-related symptoms, were independent prognostic factors determining the PMOS. The association of tumor stage and the PMOS was only seen in tumors with early relapses. The PMOS score, which was developed based on the above six factors, successfully identified patients with superior survival after metastasis. The median PMOS for patients with PMOS score less than 2 and for patients with PMOS score higher than 5 were 71.0 months and 12 months, respectively. The clinical significance of the PMOS score was further validated using independent multicenter datasets.

Conclusion: We have developed a novel prediction model that can classify breast cancer patients with distant metastasis according to their survival after metastasis. Our model can be a valuable tool to identify long-term survivors who can be potential candidates for more intensive multi-disciplinary approaches. Furthermore, out model can provide a more reliable survival information for both physicians and patients during their informed decision making process.

Identifying the potential long-term survivors among breast cancer patients with distant metastasis

Ann Oncol. 2016 May;27(5):828-33. doi: 10.1093/annonc/mdw036. Epub 2016 Jan 28.