دورية أكاديمية
أعرض في EDS

Development and Methodological Validation of a Modified Staging System for de Novo Metastatic Breast Cancer.

التفاصيل البيبلوغرافية
العنوان: Development and Methodological Validation of a Modified Staging System for de Novo Metastatic Breast Cancer.
المؤلفون: Berg T; Danish Breast Cancer Group, Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Jensen MB; Danish Breast Cancer Group, Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Rossing M; Center for Genomic Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Bechmann T; Department of Oncology, Regional Hospital West Jutland, Herning, Denmark., Donskov F; Department of Oncology, Southern Denmark University Hospital, Esbjerg, Denmark.; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark., Knoop AS; Danish Breast Cancer Group, Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Ejlertsen B; Danish Breast Cancer Group, Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
المصدر: JAMA network open [JAMA Netw Open] 2024 Mar 04; Vol. 7 (3), pp. e242174. Date of Electronic Publication: 2024 Mar 04.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Breast Neoplasms*, Aged ; Female ; Humans ; Breast ; Databases, Factual ; Retrospective Studies ; Middle Aged ; Multicenter Studies as Topic
مستخلص: Importance: Validation of a new method for prognostication of de novo metastatic breast cancer (dnMBC) to better reflect the heterogenecity of the disease.
Objective: To perform external methodological validation of the Plichta staging system, a novel prognostic system for de novo metastatic breast cancer (dnMBC).
Design, Setting, and Participants: This retrospective cohort study used a multicenter, nationwide, population-based Danish Breast Cancer Group database to validate the new method. Participants were patients with dnMBC diagnosed between 2010 and 2019. Data were analyzed from April to June 2023.
Main Outcomes and Measures: A recursive partitioning analysis (RPA) was performed, as demonstrated by Plichta and colleagues, to group patients with similar overall survival (OS) based on clinical factors. The main outcome was to group patients into 4 prognostic groups based on 3-year OS as stage IVa, greater than 70%; stage IVb, 50% to 70%; stage IVc, 25% to less than 50%; or stage IVd, less than 25%. Bootstrapping was applied for 1000 iterations, with final stage assignments based on the most commonly occurring assignment.
Results: A total of 1859 women were included with a median (IQR) age of 69 (57-77) years. With a median potential follow-up of 89.9 (95% CI, 86.4-95.1) months and a median OS of 31.7 (95% CI, 29.5-34.1) months, the RPA stratified patients into 10 groups, with organ sites, estrogen receptor status, and human epidermal growth factor receptor 2 status as the key clinical factors. Three-year survival rates ranged from 62% (95% CI, 56%-69%) to 8% (95% CI, 3%-21%), which were further combined into 3 stage groups: IVb, 59.4% (95% CI, 56.2%-62.8%); IVc, 39.4% (95% CI, 36.2%-43.0%); and IVd, 15.4% (95% CI, 11.2%-21.3%) (P < .001). Following bootstrapping, an IVa group emerged, resulting in 4 stage groups with separate 3-year OS rates identified as IVa, 75.8% (95% CI, 67.8%-84.7%); IVb, 58.8% (95% CI, 55.5%-62.3%); IVc, 39.2% (95% CI, 35.8%-43.0%); and IVd, 14.4% (95% CI, 10.8%-19.4%) (P < .001).
Conclusions and Relevance: These findings provide external and independent validation of the methods applied in the novel Plichta staging system for dnMBC. This could guide future revisions of the current American Joint Committee on Cancer staging guidelines and may be incorporated as a stratification factor in clinical trials.
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تواريخ الأحداث: Date Created: 20240313 Date Completed: 20240314 Latest Revision: 20240322
رمز التحديث: 20240323
مُعرف محوري في PubMed: PMC10938173
DOI: 10.1001/jamanetworkopen.2024.2174
PMID: 38477916
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2024.2174