Table 1.
Studies of change in survival over time for patients with metastatic breast cancer, either distant recurrence or de novo Stage IV disease
| Diagnosis period | Recurrence time periods compared | Disease status | Source population | N | Median survival (months) | Statistical significance | References |
|---|---|---|---|---|---|---|---|
| 1974–1994 | 1974–1979 to 1995–2000 | Recurrent | Adjuvant clinical trials, MD Anderson Cancer Center | 834 | 15 to 58 | UV only | Giordano et al. (25) |
| Any year | 1976–1982 to 1996–2006 | Recurrent | Single center, US | 382 | 26 to 33 | UV (no MV done) | Vogel et al., Zeichner et al. (49,50) |
| 1978–2002 | 1978–1983 to 2004–2010 | Recurrent | Adjuvant trials, US (ECOG) | 3447 | 20 | UV only | Tevaarwerk et al. (27) |
| 1979–2013 | 1979–2000 to 2001–2013 | Recurrent | Single center, Japan | 813 | 26 to 45 | UV only | Nakano et al. (28) |
| 1975–2004 | 1980–1984 to 2000–2004 | Recurrent | Single center, France | 1038 | 16 to 31 | UV only | Largillier et al. (29) |
| 1980–2005 | 1980–1994 to 1995–2008 | Recurrent | Single center, Japan | 252 | 32 to 60 | UV & MV | Tsuji et al. (30) |
| 1983–2003 | 1990–1996 to 1997–2003 | Recurrent | Single center, Japan | 321 | 25 to 34 | UV only | Anan et al. (31) |
| Any year | 1992–2000 to 2001–2008 | Recurrent | Single center, Japan | 407 | 20 to 50 | UV & MV | Shigematsu et al. (32) |
| 1976–2004 | 1979–1984 to 2000–2004 | Recurrent (90%) & stage IV | Stockholm region, Sweden | 5463 | 16 to 15 | No improvement | Foukakis et al. (33) |
| Any year | 1983–1986 to 1998–2001 | Recurrent & stage IV | Metastatic trials, Italy | 640 | 18 to 24 | UV only | Gennari et al. (34) |
| Any year | 1985–1989 to 2010–2014 | Recurrent (85%) & stage IV | Kalmar county, Sweden | 784 | 13 to 33 | UV (no MV done) | Sundquist et al. (35) |
| 1989–2001 | 1991–1992 to 1999–2001 | Recurrent (80%) & stage IV | British Columbia | 2150 | 15 to 22 | UV & MV | Chia et al. (36) |
| Any year | 1991–1994 to 2003–2006 | Recurrent & stage IV | Metastatic trials, Greece | 1361 | 15 to 31 | UV only | Dafni et al. (37) |
| Any year | 1995–2000 to 2008–2013 | Recurrent (80%) & stage IV | Single center, Germany | 716 | 33 to 35 | No improvement | Weide et al. (38) |
| Any year | 2001–2004 to 2005–2008 | Recurrent (85%) & stage IV | Single center, Italy | 70 | 35 to 30 | No improvement | Giuliani et al. (51) |
| Diagnosis period | Disease status | Source population | N | Median survival (months) | Statistical significance | References | |
| 1975–1977 to 2006–2012 | Stage IV | Multiple registries, US | NR* | 5 yr†: 19% to 34% | UV (no MV) | Jemal et al. (47), Di Meglio et al. (52) ‡ | |
| 1975–1984 to 1995–2002 | Stage IV | Eindhoven Registry, Netherlands | 1089§ | 18 to 21 | UV & MV** | Ernst et al. (41) | |
| 1985–1994 to 1995–2004 | Stage IV | City of Hope Cancer Center | 274 | 30 to 36 | No improvement | Pal et al. (42) | |
| 1987–1993 to 1994–2000 | Stage IV | Three centers, France | 724 | 23 to 29 | UV (no MV) | Andre et al. (43) | |
| 1988–1993 to 1999–2003 | Stage IV | SEER Registry, US | 15 438 | 16 to 20 | UV & MV | Dawood et al. (44), Di Meglio et al. (75) ‡ | |
| 1992–1995 to 2004–2007 | Stage IV | Saarland Registry, Germany | 984 | 5 yr†: 20% to 21% | No improvement | Holleczek et al. (40) | |
| 1995–1999 to 2005–2008 | Stage IV | Registry, Netherlands | 8031 | 17 to 23 | UV & MV†† | Ruiterkamp et al. (45) | |
| 2000–2004 to 2005–2008 | Stage IV | Registry, Czech Republic | 3766 | 5 yr†: 22% to 20% | No improvement | Pavlik et al. (48) | |
For weighting within meta-analysis, estimated N from reported confidence intervals to be approximately 6079. ECOG = Eastern Cooperative Oncology Group; HR = hazard ratio of death; MV = multivariable analysis; NR = not reported; SEER = Surveillance Epidemiology and End Results; US = United States; UV = univariate analysis.
Reported relative rather than overall survival.
In meta-regression, excluded the final time interval of this study (N = 554) as overlapped with time intervals in study (45).
Multivariable was statistically significant only comparing 1995–2002 with 1985–1994 if data on metastasis site and number were available (these prognostic factors worsened over time).
Multivariable was statistically significant only comparing 2004–2007 with 1995–1999 (trend for 2000–2003 vs 1995–1999, P = .08).