Kuru Bekir, Camlibel Mithat, Gulcelik Mehmet Ali, Alagol Haluk
Department of General Surgery, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
J Surg Oncol. 2003 Jul;83(3):167-72. doi: 10.1002/jso.10264.
The objective of this study was to identify the patients who are at low or high-risk by defining the prognostic factors in node-negative breast carcinomas.
Medical records of 384 consecutive breast cancer patients with negative axillary lymph nodes who had been operated on between January 1994 and January 1997 at our hospital were retrospectively reviewed. Several clinical and pathological characteristics of patients were categorized. Univariate analyses of survival and disease-free survival (DFS) were performed by the Kaplan-Meier method and the log-rank test. Independent prognostic and predictive factors affecting survival and DFS were assessed by Cox proportional hazard method.
5-year survival and DFS were 91.4 and 85.7%, respectively. Size, grade, age, and lymphovascular invasion (LVI) were the prognostic factors that independently affected survival and DFS. Tamoxifen improved survival and DFS. While age younger than 35 was an adverse factor for both survival and DFS, age older than 49 was a detrimental factor for DFS.
Patients who have a tumor with size greater than 2 cm, with histologic grade 3, with LVI, and patients with age under 35 or older than 49 have poorer prognosis among node-negative breast carcinomas, and are candidates for adjuvant therapy.
本研究的目的是通过确定腋窝淋巴结阴性乳腺癌的预后因素来识别低风险或高风险患者。
回顾性分析了1994年1月至1997年1月在我院接受手术的384例连续腋窝淋巴结阴性乳腺癌患者的病历。对患者的若干临床和病理特征进行了分类。采用Kaplan-Meier法和对数秩检验对生存和无病生存(DFS)进行单因素分析。通过Cox比例风险法评估影响生存和DFS的独立预后和预测因素。
5年生存率和DFS分别为91.4%和85.7%。肿瘤大小、分级、年龄和淋巴管浸润(LVI)是独立影响生存和DFS的预后因素。他莫昔芬可提高生存率和DFS。虽然年龄小于35岁对生存和DFS均为不利因素,但年龄大于49岁对DFS是有害因素。
在腋窝淋巴结阴性乳腺癌患者中,肿瘤大小大于2 cm、组织学分级为3级、有LVI的患者,以及年龄小于35岁或大于49岁的患者预后较差,是辅助治疗的候选对象。