A novel prognostic staging system for de novo metastatic breast cancer (MBC), recently reported in the Journal of Clinical Oncology, was devised by a research team using data from 42,467 patients of the National Cancer Database (NCDB) who were diagnosed with MBC between 2010 and 2016. The researchers employed recursive partitioning analysis to group patients with comparable overall survival based on various factors, including clinical T category, grade, estrogen receptor status, progesterone receptor status, HER2 status, histology, organ system site of metastasis, and amount of involved organ systems. Median 3-year overall survival rates of IVA = > 70%, IVB = 50% to 70%, IVC = 25% to < 50%, and IVD = < 25%, were established for final stages.
Two validation cohorts were used to evaluate the effectiveness of the staging model. The Surveillance, Epidemiology, and End Results group had a median follow-up of 47 months, and the staging model showed considerably different 3-year overall survival being IVA, 72.5%; IVB, 58.4%; IVC, 35.7%; and IVD, 14.6% (overall P < .001). With a median follow-up of 32.7 months in the NCDB group, the staging model also showed considerable differences in 3-year overall survival being IVA, 76.6%; IVB, 64.2%; IVC, 43.5%; and IVD, 21.1% (overall P < .001). Investigators conclude that the results of this study could potentially be used as a reference in the revision of future staging guidelines.
Reference: Stenger M. New Prognostic Staging System for De Novo Metastatic Breast Cancer. The ASCO Post. Updated March 28, 2023. Accessed April 12, 2023. https://ascopost.com/news/march-2023/new-prognostic-staging-system-for-de-novo-metastatic-breast-cancer/
