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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 by gender. (A) Disease-free survival and (B) overall survival in men. (C) Disease-free survival and (D) overall survival in women.M-H=Mantel-Haenszel; CI=confidence interval; AR=androgen receptor. *5-Year survival data.
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Figure 6: Forest plots of survival outcomes by gender. (A) Disease-free survival and (B) overall survival in men. (C) Disease-free survival and (D) overall survival in women.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 by gender are shown in Figure 6. Among all studies, articles were only included in this analysis when the gender of the patients was described or could be determined by description (such as, premenopausal, postmenopausal, etc.). Among 16 studies, we could identify the gender of the included patients in eight articles. Only one of eight research studies evaluated the survival outcomes in men. For women, AR expression was associated with longer DFS and OS (OR, 0.42, 95% CI, 0.27-0.64, p<0.001; and OR, 0.47, 95% CI, 0.38-0.59, p<0.001, respectively); in contrast, AR expression showed no statistical relation with OS in men (OR, 2.13; 95% CI, 0.55-8.14; p=0.270). Furthermore, AR expression in men was associated with a worse DFS than in patients without AR expression (OR, 6.00; 95% CI, 1.46-24.73; p=0.010).


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 by gender. (A) Disease-free survival and (B) overall survival in men. (C) Disease-free survival and (D) overall survival in women.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 6: Forest plots of survival outcomes by gender. (A) Disease-free survival and (B) overall survival in men. (C) Disease-free survival and (D) overall survival in women.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 by gender are shown in Figure 6. Among all studies, articles were only included in this analysis when the gender of the patients was described or could be determined by description (such as, premenopausal, postmenopausal, etc.). Among 16 studies, we could identify the gender of the included patients in eight articles. Only one of eight research studies evaluated the survival outcomes in men. For women, AR expression was associated with longer DFS and OS (OR, 0.42, 95% CI, 0.27-0.64, p<0.001; and OR, 0.47, 95% CI, 0.38-0.59, p<0.001, respectively); in contrast, AR expression showed no statistical relation with OS in men (OR, 2.13; 95% CI, 0.55-8.14; p=0.270). Furthermore, AR expression in men was associated with a worse DFS than in patients without AR expression (OR, 6.00; 95% CI, 1.46-24.73; p=0.010).

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