Takeuchi Hideya, Ueo Hiroaki, Tsuji Kohichi, Tokunaga Eriko, Baba Hideo, Maehara Yoshihiko
Department of Surgery, Oita Prefectural Hospital, Bunyo 476, Oita 870-8511, Japan.
Breast. 2006 Apr;15(2):226-31. doi: 10.1016/j.breast.2005.03.001. Epub 2005 Jul 7.
The clinical courses of patients with recurrent breast carcinoma vary greatly. We retrospectively examined data on 1863 Japanese patients treated for a breast carcinoma from 1981 to 2000. Among them, 345 (18.5%) who had clearly died of recurrence were reviewed. Patients died most frequently (63.2%) up to 30 months after the first recurrence. Based on multivariate analysis, the four factors that were most predictive of survival after the first recurrence were disease-free interval, site of recurrence, progesterone receptor (PgR) status, and vascular involvement. These findings showed that the intrinsic tumor biology of the initial primary tumor plays a critical role in determining survival after the first recurrence in patients with a breast carcinoma. The combined analysis of disease-free interval, site of recurrence, PgR status, and vascular involvement may assist in estimating the median survival after first recurrence, and may assist with the designing of new therapeutic strategies for patients with recurrence for whom there is an unfavorable prognosis.
复发性乳腺癌患者的临床病程差异很大。我们回顾性研究了1981年至2000年期间接受乳腺癌治疗的1863例日本患者的数据。其中，对345例（18.5%）明确死于复发的患者进行了分析。患者在首次复发后30个月内死亡最为常见（63.2%）。基于多因素分析，首次复发后对生存最具预测性的四个因素是无病间期、复发部位、孕激素受体（PgR）状态和血管侵犯。这些发现表明，初始原发性肿瘤的内在肿瘤生物学特性在决定乳腺癌患者首次复发后的生存中起着关键作用。对无病间期、复发部位、PgR状态和血管侵犯进行综合分析，可能有助于估计首次复发后的中位生存期，并可能有助于为预后不良的复发患者设计新的治疗策略。
