title: Prognostic factors and survival in metastatic breast cancer: A single institution experience.
abstract: BACKGROUND
  The current retrospective study aims to identify some determinants of survival in metastatic breast cancer.
  
  
  METHODS
  The study concerned 332 patients with synchronous (SM) or metachronous (MM) metastatic breast cancer treated between January 2000 and December 2007. Statistical comparison between subgroups of patients concerning survival was carried out employing log-rank test for the invariable analysis and Cox model for the multivariable analysis. Factors included: age group (≤50 years vs. >50; ≤70 years vs. >70; ≤35 years vs. >35), menopausal status, presentation of metastatic disease (SM vs. MM), disease free interval (DFI) (≤24 months vs. >24 months; ≤60 months vs. >60 months), performance status at diagnosis of metastatic disease (PS) (0-1 vs. >1), hormone receptors (HR), number of metastatic sites (1 site vs. >1), nature of the metastatic site (visceral vs. non visceral), first line therapy, surgery of the primary tumor (SPT), locoregional radiotherapy (LRRT) and use or not of bisphosphonates.
  
  
  RESULTS
  Overall survival at 5 years was 12%. Positive prognostic factors in univariate analysis were: age ≤ 70 years, hormono-dependence of the tumor, good PS (PS 0-1), less than two metastatic sites, no visceral metastases, DFI ≥ 24 months, SPT or LRRT. In multivariate analysis, favorable independent prognostic factors included: good PS (PS 0-1), absence of visceral metastases (liver, lung, brain) and age ≤ 70 years.
  
  
  CONCLUSIONS
  Many of the prognostic factors in metastatic breast cancer found in our study are known in the literature but some of them, like the application of locoregional treatment (radiotherapy or surgery) and the use of bisphosphonates, need to be further investigated in randomized clinical trials.
authors.affiliation: Department of Medical Oncology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia.
authors.forename: Afef
authors.initials: A
authors.lastname: Khanfir
authors.affiliation: Department of Medical Oncology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia.
authors.forename: Faiez
authors.initials: F
authors.lastname: Lahiani
authors.affiliation: Department of Medical Oncology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia.
authors.forename: Racem
authors.initials: R
authors.lastname: Bouzguenda
authors.affiliation: Department of Medical Oncology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia.
authors.forename: Ines
authors.initials: I
authors.lastname: Ayedi
authors.affiliation: Department of Radiotherapy, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia.
authors.forename: Jamel
authors.initials: J
authors.lastname: Daoud
authors.affiliation: Department of Medical Oncology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia.
authors.forename: Mounir
authors.initials: M
authors.lastname: Frikha
keywords: Breast cancer; Metastasis; Prognostic factors; Survival