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Influence of Androgen Receptor Expression on the Survival Outcomes in Breast Cancer: A Meta-Analysis.

Kim Y, Jae E, Yoon M - J Breast Cancer (2015)

Bottom Line: DFS and OS were significantly longer in patients with AR expression compared with patients without AR expression (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.40-0.90; OR, 0.53; 95% CI, 0.38-0.73, respectively).Furthermore, AR expression was associated with a longer DFS and OS in women (OR, 0.42, 95% CI, 0.27-0.64; OR, 0.47, 95% CI, 0.38-0.59, respectively).However, in men, AR expression was associated with a worse DFS (OR, 6.00; 95% CI, 1.46-24.73).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kosin University Gospel Hospital, Busan, Korea.

ABSTRACT

Purpose: Despite the fact that the androgen receptor (AR) is known to be involved in the pathogenesis of breast cancer, its prognostic effect remains controversial. In this meta-analysis, we explored AR expression and its impact on survival outcomes in breast cancer.

Methods: We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, and Ovid databases and references of articles to identify studies reporting data until December 2013. Disease-free survival (DFS) and overall survival (OS) were analyzed by extracting the number of patients with recurrence and survival according to AR expression.

Results: There were 16 articles that met the criteria for inclusion in our meta-analysis. DFS and OS were significantly longer in patients with AR expression compared with patients without AR expression (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.40-0.90; OR, 0.53; 95% CI, 0.38-0.73, respectively). In addition, hormone receptor (HR) positive patients had a longer DFS when AR was also expressed (OR, 0.63; 95% CI, 0.41-0.98). For patients with triple negative breast cancer (TNBC), AR expression was also associated with longer DFS and OS (OR, 0.44, 95% CI, 0.26-0.75; OR, 0.26, 95% CI, 0.12-0.55, respectively). Furthermore, AR expression was associated with a longer DFS and OS in women (OR, 0.42, 95% CI, 0.27-0.64; OR, 0.47, 95% CI, 0.38-0.59, respectively). However, in men, AR expression was associated with a worse DFS (OR, 6.00; 95% CI, 1.46-24.73).

Conclusion: Expression of AR in breast cancer might be associated with better survival outcomes, especially in patients with HR-positive tumors and TNBC, and women. Based on this meta-analysis, we propose that AR expression might be related to prognostic features and contribute to clinical outcomes.

No MeSH data available.


Related in: MedlinePlus

Forest plots of survival outcomes according to hormonal receptor status. (A) Disease-free survival and (B) overall survival in patients with hormonal receptor expression. (C) Disease-free survival and (D) overall survival in patients without hormonal receptor expression.M-H=Mantel-Haenszel; CI=confidence interval; AR= androgen receptor. *5-Year survival data.
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Figure 4: Forest plots of survival outcomes according to hormonal receptor status. (A) Disease-free survival and (B) overall survival in patients with hormonal receptor expression. (C) Disease-free survival and (D) overall survival in patients without hormonal receptor expression.M-H=Mantel-Haenszel; CI=confidence interval; AR= androgen receptor. *5-Year survival data.

Mentions: The survival outcomes between tumors with AR expression and those without AR expression stratified according to HR expression are shown in Figure 4. We dichotomized the hormonal receptor status into HR positive (ER+ or PR+) and negative (ER- and PR-). A total of seven articles reported data for HR status. In patients with HR-positive tumors, those with AR expression had a significantly longer DFS (OR, 0.63; 95% CI, 0.41-0.98; p=0.040). In the analysis of OS, however, the data showed no significant differences (OR, 0.53; 95% CI, 0.23-1.24; p=0.140). Similarly, in cases of HR-negative tumors, DFS showed no significant survival differences regardless of AR expression (OR, 0.89; 95% CI, 0.39-2.03; p=0.790). However, in the analysis of OS, AR expression was associated with worse survival outcomes compared with patients without AR expression (OR, 1.43; 95% CI, 1.02-2.01; p=0.040).


Influence of Androgen Receptor Expression on the Survival Outcomes in Breast Cancer: A Meta-Analysis.

Kim Y, Jae E, Yoon M - J Breast Cancer (2015)

Forest plots of survival outcomes according to hormonal receptor status. (A) Disease-free survival and (B) overall survival in patients with hormonal receptor expression. (C) Disease-free survival and (D) overall survival in patients without hormonal receptor expression.M-H=Mantel-Haenszel; CI=confidence interval; AR= androgen receptor. *5-Year survival data.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4490262&req=5

Figure 4: Forest plots of survival outcomes according to hormonal receptor status. (A) Disease-free survival and (B) overall survival in patients with hormonal receptor expression. (C) Disease-free survival and (D) overall survival in patients without hormonal receptor expression.M-H=Mantel-Haenszel; CI=confidence interval; AR= androgen receptor. *5-Year survival data.
Mentions: The survival outcomes between tumors with AR expression and those without AR expression stratified according to HR expression are shown in Figure 4. We dichotomized the hormonal receptor status into HR positive (ER+ or PR+) and negative (ER- and PR-). A total of seven articles reported data for HR status. In patients with HR-positive tumors, those with AR expression had a significantly longer DFS (OR, 0.63; 95% CI, 0.41-0.98; p=0.040). In the analysis of OS, however, the data showed no significant differences (OR, 0.53; 95% CI, 0.23-1.24; p=0.140). Similarly, in cases of HR-negative tumors, DFS showed no significant survival differences regardless of AR expression (OR, 0.89; 95% CI, 0.39-2.03; p=0.790). However, in the analysis of OS, AR expression was associated with worse survival outcomes compared with patients without AR expression (OR, 1.43; 95% CI, 1.02-2.01; p=0.040).

Bottom Line: DFS and OS were significantly longer in patients with AR expression compared with patients without AR expression (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.40-0.90; OR, 0.53; 95% CI, 0.38-0.73, respectively).Furthermore, AR expression was associated with a longer DFS and OS in women (OR, 0.42, 95% CI, 0.27-0.64; OR, 0.47, 95% CI, 0.38-0.59, respectively).However, in men, AR expression was associated with a worse DFS (OR, 6.00; 95% CI, 1.46-24.73).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kosin University Gospel Hospital, Busan, Korea.

ABSTRACT

Purpose: Despite the fact that the androgen receptor (AR) is known to be involved in the pathogenesis of breast cancer, its prognostic effect remains controversial. In this meta-analysis, we explored AR expression and its impact on survival outcomes in breast cancer.

Methods: We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, and Ovid databases and references of articles to identify studies reporting data until December 2013. Disease-free survival (DFS) and overall survival (OS) were analyzed by extracting the number of patients with recurrence and survival according to AR expression.

Results: There were 16 articles that met the criteria for inclusion in our meta-analysis. DFS and OS were significantly longer in patients with AR expression compared with patients without AR expression (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.40-0.90; OR, 0.53; 95% CI, 0.38-0.73, respectively). In addition, hormone receptor (HR) positive patients had a longer DFS when AR was also expressed (OR, 0.63; 95% CI, 0.41-0.98). For patients with triple negative breast cancer (TNBC), AR expression was also associated with longer DFS and OS (OR, 0.44, 95% CI, 0.26-0.75; OR, 0.26, 95% CI, 0.12-0.55, respectively). Furthermore, AR expression was associated with a longer DFS and OS in women (OR, 0.42, 95% CI, 0.27-0.64; OR, 0.47, 95% CI, 0.38-0.59, respectively). However, in men, AR expression was associated with a worse DFS (OR, 6.00; 95% CI, 1.46-24.73).

Conclusion: Expression of AR in breast cancer might be associated with better survival outcomes, especially in patients with HR-positive tumors and TNBC, and women. Based on this meta-analysis, we propose that AR expression might be related to prognostic features and contribute to clinical outcomes.

No MeSH data available.


Related in: MedlinePlus