TY - JOUR
T1 - Prognostic model for advanced breast carcinoma with luminal subtype and impact of hormonal maintenance
T2 - Implications for post-progression and conditional survival
AU - Carbognin, Luisa
AU - Sperduti, Isabella
AU - Ciccarese, Mariangela
AU - Fabi, Alessandra
AU - Petrucelli, Luciana
AU - Vari, Sabrina
AU - Forcignanò, Rosa Chiara
AU - Nortilli, Rolando
AU - Vicentini, Cecilia
AU - Pilotto, Sara
AU - Merler, Sara
AU - Zampiva, Ilaria
AU - Brunelli, Matteo
AU - Manfrin, Erminia
AU - Giannarelli, Diana
AU - Tortora, Giampaolo
AU - Bria, Emilio
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background: The aim of this analysis was to develop and validate a prognostic model for advanced breast cancer (ABC) with luminal subtype based on the combination of clinical, pathological and therapeutic predictors to provide a practical tool to evaluate patients' prognosis. Methods: Clinical and pathological data were retrospectively correlated to progression-free and overall survival (PFS/OS) using a Cox model. Significant treatment variables were adjusted with the propensity score analysis. A continuous score to identify risk classes was derived according to model ratios. The performance of the risk-class model was tested for post-progression survival (PPS) and conditional survival (CS) as well. Results: Data from 335 patients (3 institutions) were gathered (median follow-up 58 months). At multivariate analysis Ki67, Performance Status (PS) and number of metastatic sites were significant predictors for PFS, whereas Ki67, PS, brain metastases, PFS after 1st-line therapy, number of chemotherapy lines, hormonal therapy and maintenance were significant predictors for OS. The hormonal maintenance resulted to be prognostic after adjustment with propensity score analysis. A two-class model significantly differentiated low-risk and high-risk patients for 2-year PFS (31.5% and 11.0%, p <0.0001), and 3-years OS (57.1% and 4.8%, p <0.0001). A three-class model separated low risk, intermediate-risk, and high-risk patients for 2-year PFS (40.8%, 24.4%, and 11.0%, p <0.0001) and 3-year OS (68.1%, 24.8%, and 4.8%, p <0.0001). Both models equally discriminate the luminal ABC prognosis in terms of PPS and CS. Conclusions: A risk stratification model including 'easy-to-obtain' clinical, pathological and therapeutic parameters accurately separates luminal ABC patients into different risk classes.
AB - Background: The aim of this analysis was to develop and validate a prognostic model for advanced breast cancer (ABC) with luminal subtype based on the combination of clinical, pathological and therapeutic predictors to provide a practical tool to evaluate patients' prognosis. Methods: Clinical and pathological data were retrospectively correlated to progression-free and overall survival (PFS/OS) using a Cox model. Significant treatment variables were adjusted with the propensity score analysis. A continuous score to identify risk classes was derived according to model ratios. The performance of the risk-class model was tested for post-progression survival (PPS) and conditional survival (CS) as well. Results: Data from 335 patients (3 institutions) were gathered (median follow-up 58 months). At multivariate analysis Ki67, Performance Status (PS) and number of metastatic sites were significant predictors for PFS, whereas Ki67, PS, brain metastases, PFS after 1st-line therapy, number of chemotherapy lines, hormonal therapy and maintenance were significant predictors for OS. The hormonal maintenance resulted to be prognostic after adjustment with propensity score analysis. A two-class model significantly differentiated low-risk and high-risk patients for 2-year PFS (31.5% and 11.0%, p <0.0001), and 3-years OS (57.1% and 4.8%, p <0.0001). A three-class model separated low risk, intermediate-risk, and high-risk patients for 2-year PFS (40.8%, 24.4%, and 11.0%, p <0.0001) and 3-year OS (68.1%, 24.8%, and 4.8%, p <0.0001). Both models equally discriminate the luminal ABC prognosis in terms of PPS and CS. Conclusions: A risk stratification model including 'easy-to-obtain' clinical, pathological and therapeutic parameters accurately separates luminal ABC patients into different risk classes.
KW - Advanced breast
KW - Breast cancer
KW - Luminal
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=84977470344&partnerID=8YFLogxK
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U2 - 10.1016/j.breast.2016.06.021
DO - 10.1016/j.breast.2016.06.021
M3 - Article
AN - SCOPUS:84977470344
VL - 29
SP - 24
EP - 30
JO - Breast
JF - Breast
SN - 0960-9776
ER -