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However, there are few reports from large-scale databases on the survival risk factors in ER+ ABC. The Safari study (UMIN000015168) was a retrospective, multicenter cohort study involving 1072 Japanese patients receiving fulvestrant 500\u00a0mg mostly as a second- or later-line endocrine therapy for ER+ ABC. The follow-up data after the Safari study were examined, focusing on any relationship between clinicopathological factors and overall survival (OS) in ER+ ABC patients.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>OS in patients with ER+ ABC was analyzed by univariate and multivariate analyses with a Cox proportional hazards model in this study.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 1031 cases were evaluable for OS analysis. Multivariate analysis showed that younger age (&lt;\u200960\u00a0years), longer time from ABC diagnosis to fulvestrant use (\u2265\u20093\u00a0years), no prior palliative chemotherapy before fulvestrant use, and progesterone receptor (PgR) negativity (PgR\u2212) were significantly correlated with prolonged OS (median 7.0\u00a0years). For cases with histological or nuclear grade data, lower histological or nuclear grades were also correlated with longer OS. In recurrent metastatic cases, long disease-free interval (DFI) was not correlated with longer OS.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In ER+ ABC patients whose treatment history included fulvestrant, younger age, longer time from ABC diagnosis to fulvestrant use, no prior palliative chemotherapy use, PgR\u2212, and lower histological or nuclear grade correlated positively with prolonged OS.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s12282-019-01029-3","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T09:02:57Z","timestamp":1575622977000},"page":"389-398","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors associated with prolonged overall survival in patients with postmenopausal estrogen receptor-positive advanced breast cancer using real-world data: a follow-up analysis of the JBCRG-C06 Safari study"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0811-9335","authenticated-orcid":false,"given":"Hidetoshi","family":"Kawaguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norikazu","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenjiro","family":"Aogi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisei","family":"Anan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichiro","family":"Ohtani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigehira","family":"Saji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimi","family":"Takano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eriko","family":"Tokunaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seigo","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshie","family":"Hasegawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Hattori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomomi","family":"Fujisawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Morita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshinari","family":"Yamashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Yotsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Toi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Ohno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"1029_CR1","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.1016\/S0140-6736(14)60488-8","volume":"383","author":"P McGale","year":"2014","unstructured":"EBCTCG (Early Breast Cancer Trialists\u2019 Collaborative Group), McGale P, Taylor C, Correa C, Cutter D, Duane F, et al. 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Kawaguchi received personal fees from Pfizer, Chugai, AstraZeneca, Eli Lilly, Eisai, Kyowa Kirin, Novartis, Taiho.Takeda. N. Masuda received grants, personal fees, and other from Chugai and Eisai, personal fees and other from AstraZeneca, Pfizer, Eli-Lilly, Takeda, Kyowa-Kirin, Novartis, and Daiichi Sankyo, and other from MSD. T. Nakayama received personal fees from AstraZeneca, Chugai, Novartis, Eli Lilly, Pfizer, Takeda. Taiho. K. Aogi received grants and personal fees from Eisai, personal fees from AstraZeneca, Daiichi Sankyo, Chugai, Taiho, Eli Lilly, Mochida, and Ono. K. Anan received personal fees from Pfizer, Chugai, AstraZeneca, Eisai and Novartis. Y. Ito received grants from Daiichi Sankyo, Chugai, Novartis, Parexel, EPS, MSD, AstraZeneca, Eli Lilly, Kyowa Hakko Kirin, Covance, Taiho, A2 Healthcare, QVIA services Japan, and Esai. S. Ohtani received personal fees from AstraZeneca, Pfizer, and Chugai. N. Sato received personal fees from AstraZeneca, Chugai, Eisai, and Taiho. S. Saji received grants and personal fees from Eisai, Chugai, AstraZeneca, Takeda, Novartis, Taiho, and Nihon Kayaku, personal fees from Kyowa Hakko Kirin, Pfizer, and Daiichi Sankyo, and grants from Ono. T. Takano received grants and personal fees from Daiichi Sankyo, Kyowa Hakko Kirin, and Eisai, grants from Ono, MSD, Merck Serono, Taiho, Novartis, and Chugai, and personal fees from Pfizer and Eli Lilly. E. Tokunaga received personal fees from Astra Zeneca and Pfizer. S. Nakamura received grants and personal fees from Novartis, Taiho and Takeda, grants from Pfizer; and personal fees from Nippon Kayaku and Shionogi. S. Morita received personal fees from Astra Zeneca. M. Yamaguchi received personal fees from Eli Lilly, Pfizer, Chugai Astra Zeneca, and Eisai. H. Yamashita received personal fees from Astra Zeneca, Takeda, Pfizer, Chugai Hitachi, Taiho, Daiichi Sankyo, Kyowa Hakko Kirin, Eli Lilly, Novartis, Nippon Kayaku, and Eisai. T. Yamashita received grants and other from Chugai, Nippon Kayaku, and Kyowa Hakko Kirin, and other from Eisai, Novartis Pharma, Taiho, AstraZeneca, and Pfizer. Dr. Yamamoto received personal fees from AstraZeneca, Pfizer, Nippon Kayaku, Kyowa Hakko Kirin, Chugai, Esai, Eli Lilly, Takeda, Sysmex, GE Health Care, and Daiich Sankyo. M. Toi received grants and personal fees from Taiho, Chugai, Takeda, Shimadzu, Eisai, Daiichi Sankyo, Pfizer, AstraZeneca, C&C Res Lab, and Kyowa-Hakko-Kirin, personal fees from Yakult, Konica-Minolta, Eli Lilly, MSD, Genomic Health, Novartis, Nihon Kayaku, and Ono, grants and non-financial support from Jpn Breast Cancer Research Group association, and non-financial support from Jpn Society Clinical Oncology, Jpn Surgical Society, Jpn Breast Cancer Society, Jpn Breast Cancer Research Group organization, Organisation for Oncology and Translational Research, and Kyoto Breast Cancer Research Network. S. Ohno received grants and personal fees from Eisai and Taiho, and personal fees from AstraZeneca, Chugai, Pfizer, Novartis, Nippon Kayaku, Kyowa Hakko Kirin, and Eli Lilly. Y. Hasegawa, Masaya Hattori, T. Fujisawa, and D. Yotsumoto have no financial or other relationships to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}