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KMID : 1134120180210010037
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Journal of Breast Cancer
2018 Volume.21 No. 1 p.37 ~ p.44
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Endocrine Treatment-Related Symptoms and Patient Outcomes in Breast Cancer: A Meta-Analysis
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Yoo Tae-Kyung
Jang Myoung-Jin
Lee Eun-Shin
Moon Hyeong-Gon
Noh Dong-Young
Han Won-Shik
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Abstract
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Purpose: An association between endocrine treatment-related symptoms and breast cancer recurrence has been suggested previously; however, conflicting results have been reported. We performed a meta-analysis of published studies to clarify this relationship.
Methods: We systematically searched PubMed, Embase, Scopus, and the Cochrane database for studies investigating the association between endocrine treatment-related symptoms and patient survival. Random-effects meta-analysis was conducted with recurrence rate as the primary outcome.
Results: Out of 7,713 retrieved articles, six studies were included. In patients who received endocrine treatment, the presence of any endocrine treatment-related symptom was found to be associated with a lower recurrence rate in comparison to an absence of any symptoms (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.66?0.87). This relationship persisted in patients presenting with only vasomotor or only musculoskeletal symptoms (HR, 0.74, 95% CI, 0.63?0.87; HR, 0.69, 95% CI, 0.55?0.86, respectively). At both time-points of symptom evaluation (3 months and 12 months), patients with endocrine treatment-related symptoms had a lower recurrence rate (HR, 0.74, 95% CI, 0.66?0.84; HR, 0.79, 95% CI, 0.69?0.90, respectively). This association was also significant in pooled studies including patients with and without baseline symptoms (HR, 0.73, 95% CI, 0.54?0.99; HR, 0.76, 95% CI, 0.69?0.85, respectively).
Conclusion: Endocrine treatment-related symptoms are significantly predictive of lower recurrence rate in breast cancer patients, regardless of the type of symptoms, time-point of evaluation, or inclusion of baseline symptoms. These symptoms could be biomarkers for the prediction of long-term responses to endocrine treatment in patients with breast cancer.
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KEYWORD
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Breast neoplasms, Disease-free survival, Drug-related side effects and adverse reactions, Hormonal antineoplastic agent, Meta-analysis
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