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非转移性男性乳腺癌的结局:118 例患者。

Outcome of non-metastatic male breast cancer: 118 patients.

机构信息

Department of 2nd Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.

出版信息

Med Oncol. 2012 Jun;29(2):554-60. doi: 10.1007/s12032-011-9978-9. Epub 2011 May 15.

Abstract

Studies concerning adjuvant systemic therapy and prognosis in male breast carcinoma (MBC) are limited. We aimed to evaluate outcome of the changing practices of adjuvant systemic treatment and survival in operable MBC patients over the last two decades. The medical records of 148 MBC patients followed between the years 1986 and 2009 at 7 cancer center were evaluated retrospectively. One hundred and eighteen operable non-metastatic patients had sufficient data were included the study. One hundred and eighteen operable MBC were found to be eligible. Median age was 60 (range 29-83) years. Thirty-two percent of the patients had T3-4 tumors. Half of the patients had axillary lymph node-positive disease. The proportion of positivity of estrogen receptor(ER), progesterone receptor (PgR), and HER2 status were 82.9, 75.8, and 23.4%, respectively. Only, 7 patients had triple negative (TN). Adjuvant hormonotherapy was advised for 76.8% whereas adjuvant chemotherapy for 73.7% of the patients. Median follow-up was 40.9 months (range 3.8-186 months). Locoregional and/or distant recurrence developed in thirty-eight patients (32.2%). Twenty-three patients died during the follow-up period. Five-year disease-free survival (DFS) was found to be 60%, whereas overall survival (OS) was 82%. Larger tumor size and lymph node positivity were statistically significant poor prognostic factors for OS. Although statistical insignificant, patients with HER2-positive tumors have worse DFS (52 vs. 120 months, log rank P = .73) and OS (85 vs. 144 months, log rank P = .30) than HER2-negative ones. Although the frequency of the use of adjuvant systemic therapy in MBC has been increasing and survival rates improving for the last decades, lymph node status and tumor size are still the most important determining factors for prognosis. There is a need for further prognostic information in men with HER2-positive or TN breast cancer.

摘要

关于男性乳腺癌(MBC)辅助全身治疗和预后的研究有限。我们旨在评估过去二十年中辅助全身治疗方法的变化和可手术 MBC 患者生存情况的变化。回顾性分析了 1986 年至 2009 年在 7 家癌症中心接受治疗的 148 例 MBC 患者的病历。对 118 例可手术非转移性患者进行了足够的数据分析,并将这些患者纳入了本研究。118 例可手术的 MBC 患者被认为符合条件。中位年龄为 60 岁(范围 29-83 岁)。32%的患者有 T3-4 期肿瘤。一半的患者有腋窝淋巴结阳性疾病。雌激素受体(ER)、孕激素受体(PgR)和 HER2 状态的阳性比例分别为 82.9%、75.8%和 23.4%。只有 7 例患者为三阴性(TN)。建议 76.8%的患者接受辅助激素治疗,73.7%的患者接受辅助化疗。中位随访时间为 40.9 个月(范围 3.8-186 个月)。38 例患者(32.2%)出现局部区域和/或远处复发。23 例患者在随访期间死亡。5 年无病生存率(DFS)为 60%,总生存率(OS)为 82%。肿瘤体积较大和淋巴结阳性是 OS 的统计学上显著的不良预后因素。尽管统计学上无显著性差异,但 HER2 阳性肿瘤患者的 DFS(52 个月与 120 个月,对数秩检验 P=.73)和 OS(85 个月与 144 个月,对数秩检验 P=.30)均较差。尽管过去几十年中 MBC 辅助全身治疗的频率有所增加,生存率也有所提高,但淋巴结状态和肿瘤大小仍然是预后的最重要决定因素。HER2 阳性或 TN 乳腺癌男性患者需要进一步的预后信息。

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