Prediction of outcome after diagnosis of metachronous XXXX .

@entity1 @entity0 @entity5 @entity52454 @entity3
BACKGROUND: Although 2-20% of @entity0 @entity1 develop a @entity0 ( @entity0 ), prognosis after @entity0 is still debated. Using a unique @entity1 cohort, we have investigated whether time interval to second @entity0 ( @entity52454 ) and mode of detection are associated to prognosis. METHODS: Information on @entity1 -, @entity5 -, treatment-characteristics, and outcome was abstracted from @entity1 ' individual charts for all @entity1 diagnosed with metachronous @entity0 in the Southern Healthcare Region of Sweden from 1977-2007. Distant disease-free survival (DDFS) and risk of distant @entity3 were primary endpoints. RESULTS: The cohort included 723 @entity1 with metachronous @entity0 as @entity0 event. @entity1 with less than three years to @entity52454 had a significantly impaired DDFS (p = 0.01), and in sub-group analysis, this effect was seen primarily in @entity1 aged <50. By logistic regression analysis, @entity1 diagnosed with @entity52454 within routine follow-up examinations had a significantly lower risk of developing @entity3 compared to those who were symptomatic at diagnosis (p < 0.0001). Chemotherapy given after breast BC1 was a negative prognostic factor for DDFS, whereas endocrine treatment and radiotherapy given after @entity52454 improved DDFS. CONCLUSIONS: In a large cohort of @entity1 with @entity0 , we found the time interval to @entity52454 to be a strong prognostic factor for DDFS in young @entity1 and mode of detection to be related to risk of distant @entity3 . Future studies of @entity5 biology of @entity52454 in relation to prognostic factors found in the present study can hopefully provide biological explanations to these findings.
