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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 molecular subtypes. (A) Disease-free survival and (B) overall survival in patients with triple-negative breast cancer (TNBC). (C) Disease-free survival and (D) overall survival in patients with non-TNBC.M-H=Mantel-Haenszel; CI=confidence interval; AR=androgen receptor.
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Figure 5: Forest plots of survival outcomes according to molecular subtypes. (A) Disease-free survival and (B) overall survival in patients with triple-negative breast cancer (TNBC). (C) Disease-free survival and (D) overall survival in patients with non-TNBC.M-H=Mantel-Haenszel; CI=confidence interval; AR=androgen receptor.

Mentions: Figure 5 shows the survival association between AR expression and molecular subtype. We dichotomized the molecular subtypes into triple-negative breast cancer (TNBC) and non-TNBC. Among all studies, articles were only included in this analysis if the article showed the status of all three receptors (i.e., ER, PR, and human epidermal growth factor receptor 2 [HER2]). A total of five studies reported data for molecular subtypes. With regard to TNBC, AR expression was associated with a significantly longer DFS and OS (OR, 0.44, 95% CI, 0.26-0.75, p=0.002; and OR, 0.26, 95% CI, 0.12-0.55, p<0.001, respectively). In contrast, there were no survival benefits of AR expression in patients with non-TNBC (OR, 0.75, 95% CI, 0.42-1.33, p=0.320; and OR, 0.72, 95% CI, 0.29-1.76, p=0.470 for DFS and OS, respectively).


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 molecular subtypes. (A) Disease-free survival and (B) overall survival in patients with triple-negative breast cancer (TNBC). (C) Disease-free survival and (D) overall survival in patients with non-TNBC.M-H=Mantel-Haenszel; CI=confidence interval; AR=androgen receptor.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Forest plots of survival outcomes according to molecular subtypes. (A) Disease-free survival and (B) overall survival in patients with triple-negative breast cancer (TNBC). (C) Disease-free survival and (D) overall survival in patients with non-TNBC.M-H=Mantel-Haenszel; CI=confidence interval; AR=androgen receptor.
Mentions: Figure 5 shows the survival association between AR expression and molecular subtype. We dichotomized the molecular subtypes into triple-negative breast cancer (TNBC) and non-TNBC. Among all studies, articles were only included in this analysis if the article showed the status of all three receptors (i.e., ER, PR, and human epidermal growth factor receptor 2 [HER2]). A total of five studies reported data for molecular subtypes. With regard to TNBC, AR expression was associated with a significantly longer DFS and OS (OR, 0.44, 95% CI, 0.26-0.75, p=0.002; and OR, 0.26, 95% CI, 0.12-0.55, p<0.001, respectively). In contrast, there were no survival benefits of AR expression in patients with non-TNBC (OR, 0.75, 95% CI, 0.42-1.33, p=0.320; and OR, 0.72, 95% CI, 0.29-1.76, p=0.470 for DFS and OS, respectively).

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