Overall survival (OS) of patients with metastatic breast cancer (MBC) has improved within controlled clinical trials. Whether these advances translate into improved OS in routine care is controversial. We therefore analyzed retrospectively unselected female patients from five oncology group practices and one university outpatient clinic, whose initial diagnosis of MBC was between 1995 and 2022. A total of 1610 patients with a median age of 63 years (23–100) were evaluated. In all, 82.9% had hormone-receptor-positive disease, and 23.8% were HER2-positive. Evaluation in time cohorts by initial MBC diagnosis date showed a continuous prolongation of median OS from 31.6 months (0.5–237.3+) (1995–2000) to 48.4 months (0.4–61.1+) (2018–2022) (p= 0.003). Univariable analyses showed a significant dependence on the time cohort of diagnosis, metastatic status at initial diagnosis, age at metastasis, hormone and HER2 status, general condition, metastasis localization, and the number of affected organs. A multivariable analysis revealed a significant dependence of survival probability on receptor status, general condition, and number of metastatic sites, as well as the time between initial breast cancer diagnosis and the diagnosis date of MBC in months. In sum, OS of patients with MBC has improved continuously and significantly in routine care over the last 27 years.
在临床试验中，转移性乳腺癌（MBC）患者的总体生存期（OS）已有所改善。然而，这些进展是否转化为常规临床实践中OS的提升仍存在争议。为此，我们回顾性分析了来自五家肿瘤专科诊所和一家大学门诊部的未经筛选的女性患者数据，这些患者的MBC初诊时间介于1995年至2022年之间。共评估了1610名患者，中位年龄为63岁（范围23-100岁）。其中，82.9%的患者为激素受体阳性，23.8%为HER2阳性。按MBC初诊时间进行队列分析显示，中位OS从1995-2000年间的31.6个月（范围0.5-237.3+）持续延长至2018-2022年间的48.4个月（范围0.4-61.1+）（p=0.003）。单变量分析表明，OS与诊断时间队列、初诊时的转移状态、转移发生时的年龄、激素及HER2状态、一般状况、转移部位以及受累器官数量显著相关。多变量分析进一步揭示，生存概率显著依赖于受体状态、一般状况、转移灶数量，以及从乳腺癌初诊到MBC确诊的时间间隔（以月计）。总之，在过去27年中，MBC患者在常规临床实践中的OS得到了持续且显著的改善。
Metastatic Breast Cancer: Prolonging Life in Routine Oncology Care
肿瘤(癌症)患者之家