-Original-

Comparison of Outcomes between Women with De novo Stage IV and Relapsed Breast Cancer

Dai Kitagawa^1,3, Shin-ichiro Horiguchi², Toshinari Yamashita¹, Katsumasa Kuroi¹ and Kazuo Shimizu³

¹Division of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
²Division of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital
³Department of Endocrine Surgery, Nippon Medical School

Background: Patients with de novo stage IV and relapsed breast cancer are often treated with the same strategy. However, survival differences have recently been reported between the disease types.
Purpose: The aim of this study was to compare outcomes between de novo stage IV disease and relapsed disease and to discuss any differences in prognostic factors between them.
Patients and Methods: The subjects were 79 patients with de novo stage IV disease and 213 patients with relapsed disease treated at the Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, from October 2001 through November 2010. The Kaplan-Meier method was used to estimate overall survival (OS), and the Cox proportional hazards model was used to examine the association between metastatic disease and OS.
Results: The median follow-up period was 32 months for de novo stage IV disease and 34 months for relapsed disease. The median OS was 46 months and 43 months, respectively. No significant differences were evident. Identified prognostic factors were performance status and liver metastasis for de novo stage IV disease, and performance status, hormone receptor status, solitary bone metastasis, and disease-free interval for relapsed disease.
Conclusion: No differences in outcome were found between de novo stage IV disease and relapsed disease. However, their prognostic factors differed substantially and suggest that different treatment strategies may be warranted for metastatic disease in each type of breast cancer.

J Nippon Med Sch 2014; 81: 139-147

Keywords
breast cancer, de novo stage IV, metastatic breast cancer, prognostic factor

Correspondence to
Dai Kitagawa, MD, Division of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
moon1121diver@yahoo.co.jp

Received, October 23, 2013
Accepted, December 24, 2013