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已发表论文
乳腺癌远处微转移的预后价值：一项基于人群的倾向评分匹配研究
Authors Luo S, Wang Y, Zhao J , Ding L, Wu W, Zeng Y, Tang S
Received 24 August 2025
Accepted for publication 1 December 2025
Published 10 December 2025 Volume 2025:17 Pages 5343—5354
DOI https://doi.org/10.2147/IJWH.S562910
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Vinay Kumar
Simin Luo,1,2 Ying Wang,1,2 Jianli Zhao,1,2 Linxiaoxiao Ding,1,2 Wenjing Wu,1,2 Yinduo Zeng,1,2 Song Tang3
1Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People’s Republic of China; 2Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou Regenerative Medicine and Health; Guangdong Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, People’s Republic of China; 3The Second Department of General Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, People’s Republic of China
Correspondence: Song Tang, The Second Department of General Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, People’s Republic of China, Email tangsong0802@163.com Yinduo Zeng, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, People’s Republic of China, Email zengyd3@mail.sysu.edu.cn
Background: Distant micrometastasis of breast cancer [M0(i+)] is an emerging metastatic stage that has not yet received widespread attention. This study aimed to compare M0(i+) patients with traditional M0 patients and to evaluate the prognostic value of M0(i+).
Methods: Using data from the SEER database (2018– 2022), we identified 283,503 M0 patients and 585 M0(i+) patients. Propensity score matching (PSM) was applied to control for confounding factors in intergroup comparisons. Overall survival (OS) and breast cancer–specific mortality (BCSM) were assessed using the Kaplan–Meier method, Cox regression analysis, the cumulative incidence function (CIF), and the Fine–Gray competing risk model.
Results: After matching, no statistically significant differences were observed between the M0(i+) and M0 groups in either OS or BCSM (OS: HR=0.803, P=0.369; BCSM: HR=1.273, P=0.450). Nevertheless, the M0(i+) group showed a slightly worse survival trend in BCSM, while demonstrating a survival advantage in OS. This advantage may be influenced by the higher proportion of non–cancer-related deaths in this group.
Conclusion: The prognosis of M0(i+) patients is similar to that of M0 patients, supporting the rationale for combining the two stages in the AJCC staging system. Although the differences did not reach statistical significance, M0(i+) may still carry potential adverse prognostic implications. In light of prior literature, further refinement of the M0(i+) classification should be considered, with particular attention to the prognostic role of bone marrow micrometastasis.
Keywords: breast cancer, distant micrometastasis, AJCC, prognostic value, SEER
1Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People’s Republic of China; 2Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou Regenerative Medicine and Health; Guangdong Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, People’s Republic of China; 3The Second Department of General Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, People’s Republic of China
Correspondence: Song Tang, The Second Department of General Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, People’s Republic of China, Email tangsong0802@163.com Yinduo Zeng, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, People’s Republic of China, Email zengyd3@mail.sysu.edu.cn
Background: Distant micrometastasis of breast cancer [M0(i+)] is an emerging metastatic stage that has not yet received widespread attention. This study aimed to compare M0(i+) patients with traditional M0 patients and to evaluate the prognostic value of M0(i+).
Methods: Using data from the SEER database (2018– 2022), we identified 283,503 M0 patients and 585 M0(i+) patients. Propensity score matching (PSM) was applied to control for confounding factors in intergroup comparisons. Overall survival (OS) and breast cancer–specific mortality (BCSM) were assessed using the Kaplan–Meier method, Cox regression analysis, the cumulative incidence function (CIF), and the Fine–Gray competing risk model.
Results: After matching, no statistically significant differences were observed between the M0(i+) and M0 groups in either OS or BCSM (OS: HR=0.803, P=0.369; BCSM: HR=1.273, P=0.450). Nevertheless, the M0(i+) group showed a slightly worse survival trend in BCSM, while demonstrating a survival advantage in OS. This advantage may be influenced by the higher proportion of non–cancer-related deaths in this group.
Conclusion: The prognosis of M0(i+) patients is similar to that of M0 patients, supporting the rationale for combining the two stages in the AJCC staging system. Although the differences did not reach statistical significance, M0(i+) may still carry potential adverse prognostic implications. In light of prior literature, further refinement of the M0(i+) classification should be considered, with particular attention to the prognostic role of bone marrow micrometastasis.
Keywords: breast cancer, distant micrometastasis, AJCC, prognostic value, SEER