Estimating Probability of Co-occurrence of Metastasis and Death at Certain Intervals after Surgery in Patients with Breast Cancer
,
Abstract
Background: Breast cancer is one of the most prevalent cancers and significant causes of mortality in women. An important problem is the cancer cell metastasis in other organs.Different mechanisms in the beginning, progression, and metastasis of breast cancer makes it difficult to determine patients’ ultimate fate (prognosis) and lifespan specifically although events ahead of the patients can be estimated using probabilities. This study was conductedto estimate the probability for the co-occurrence of metastasis and death at certain intervals of 5 years after surgery and 5 years after metastasis in patients with breast cancer.Methods: In this retrospective study, the data were collected from 608 women having breast cancer and going to the Breast Disease Center of ACECR in 2009-2001. The patients were studied from the time of surgery, and the two events were metastasis anddeath, respectively. The interval between the surgery and metastasis and that between the metastasis and death caused by cancer or end of follow-ups (for patients who did not die) were measured and analyzed in month. The probability for co-occurrence of the two intervals was estimated using the semiparametric method suggested by Una-Alvarez (2011)and R statistical software.Results: Median time for the occurrence of metastasis after surgery and duration of followup were 34 months and 66 months, respectively. In total, 93 metastases and 46 deaths occurred. The co-occurrence probability interval for all samples was 0.087-0. It was found that the probability for co-occurrence of the two events in patients with more than 50 years old, a tumor larger than 5 cm, lymph node involvement, high stage of the disease, positive HER2, negative ER, and without radiotherapy was greater than that in other groups.Conclusion: Considering the estimated co-occurrence probabilities, it seemed that factors such as the age over 50 years, tumors larger than 5 cm, lymph node involvement, higher stages, positive HER2, and negative ER increased the probability for the co-occurrence of metastasis and death in breast cancer patients.Mirmalek SA. ElhamKani F. Clinical Application of Breast Can- cer Biology, Review of Literature. Journal of Surgery 2009; 17(1): 1-17.
Rugo HS. The importance of distance metastases hormon-sensi- tive breast cancer. The breast 2008; 17(51): 53-8.
Iranian annual national cancer registration report H.a.T.D. IS- LAMIC REPUBLIC of IRAN Ministry of Health and Medical Edu- cation and Center, Editors. 2008-2009, 2011.
Mohagheghi MA. Cancer Incidence in Tehran Metropolis: The First Report from the Tehran Population-Based Cancer Registry, 1998 – 2001. Arch Iranian Med 2009; 12(1): 15-23.
Gao D. Risk Factors for Initial Lung Metastasis from Breast In- vasive Ductal Carcinoma in Stages I–III of Operable Patients. Jpn J Clin Oncol 2009; 39(2): 97-104.
Oltean, D, Dicu T, Eniu D. Brain metastases secondary to breast cancer: symptoms, prognosis and evolution. Tumori 2009; 95: 697- 701.
Goldfarb Y. Ben-Eliyahu S. Surgery as a Risk Factor for Breast Cancer Recurrence and Metastasis: Mediating Mechanisms and Clinical Prophylactic Approaches. Breast Disease journal 2005; 24: 1-16.
Mirzaiee H, Hajian S, Mofid B. The role of prognostic factors in breast cancer recurrence in patients referred to radiotherapy-Oncol- ogy in Imam Hossein Hospital. Iranian Journal of Breast Disease 2008. 1(2): 18-23.
JalaliNadoushan M., Davati A, Tavakolyfar A. Expression of Bcl-2 gen in primary breast cancer and its correlation with prognos- tic factors. Journal of Mazandaran University of Medical Sciences 2007; 17(1): 30-6.
JalaliNadoushan M, Davati A, bakhshaiesh S. Expression status of Katpsyn D in primary breast cancer and its correlation with prog- nostic factors. Journal of Hamedan University of Medical Sciences 2007; 14(3): 48-53.
JalaliNadoushan M, Davati A, Akhavan F. Expression of E-cad- herin in primary breast cancer and its correlation with prognostic factors. Journal of Shahrekord University of Medical Sciences 2009; 11(3): 55-60.
Un˜a-A´lvarez Jd, Amorim AP. A semiparametric estimator of the bivariate distribution function for censored gap times. Biometri- cal Journal 2011; 53(1): 113-27.
Welch DR. Breast cancer metastasis to bone: Evolving models and research challenges. J Musculoskel Neuron Interact 2003; 3(1): 30-8.
Li CI. Breast Cancer Epidemiology 2010, New York: Springer.
Kuru B. Prognostic factors for survival in breast cancer patients who developed distant metastasis subsequent to definitive surgery. Singapore Med J 2008; 49(11): 904-11.
Nam BH. Breast cancer subtypes and survival in patients with brain metastases. Breast Cancer Research 2008; 10(1): 1-8.
Rezaianzadeh A. Survival analysis of 1148 women diagnosed with breast cancer in Southern Iran. BMC Cancer 2009; 9: 168-79.
Harputluoglu H. Characteristics of Breast Cancer Patients with Central Nervous System Metastases: A Single-Center Experience. Journal Of The National Medical Association 2008; 100(5): 521-6.
Kwon HC. Clinical Outcomes in Patients with Triple-negative Breast Cancer and Brain Metastases. J Breast Cancer 2010; 13(2): 160- 6.
Weaver DL. Effect of Occult Metastases on Survival in Node-Negative Breast Cancer. The new engl and journal of med- icine 2011.
| Files | ||
| Issue | Vol 7 No 1 (2015) | |
| Section | Original Articles | |
| Keywords | ||
| Recurrent events probability stage of the disease lymph node involvement HER2 ER | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
