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局部区域外肿瘤扩散是否是早期乳腺癌患者的预后因素?

Is extracapsular tumour spread a prognostic factor in patients with early breast cancer?

机构信息

Department of Medical Oncology, University Hospital of Besancon, Besançon, France.

出版信息

Int J Clin Oncol. 2013 Aug;18(4):607-13. doi: 10.1007/s10147-012-0439-z. Epub 2012 Jul 5.

Abstract

BACKGROUND

This study searched for extra capsular tumour spread (ECS) as a prognostic factor for recurrence in terms of Disease Free Survival (DFS) and Overall Survival (OS).

PATIENTS AND METHODS

For this study, from a retrospective database of the Doubs cancer registry, 823 eligible women with node positive breast cancer treated from February 1984 to November 2000 were identified. The following factors were evaluated: ECS, numbers of involved nodes, histological tumour grade, tumour size, status of estrogen and progesterone receptors, and age of patient. A Cox proportional hazards method was used to search for significant factors related to OS and DFS length.

RESULTS

In the multivariate analysis, factors related to DFS length were found to be: tumour grade (aHR 0.76, 95 % CI 0.61-0.96, p = 0.02), ECS status (aHR 0.7, 95 % CI 0.49-0.96, p = 0.03), progesterone (PgR) status (aHR 0.63, 95 % CI 0.44-0.85 p = 0.008), number of nodes involved (aHR 0.75, 95 % CI 0.56-1, p = 0.05). The multivariate analysis for OS found as significant factors: tumour grade (aHR 0.76, 95 % CI 0.61-0.95; p = 0.02) and PgR status (aHR 0.8, 95 % CI 0.56-0.99, p = 0.02).

CONCLUSIONS

This study might suggest taking into account ECS status in the adjuvant decision-making process.

摘要

背景

本研究旨在寻找包膜外肿瘤扩散(ECS)作为无病生存(DFS)和总生存(OS)方面的复发预后因素。

患者和方法

本研究从多布斯癌症登记处的回顾性数据库中,确定了 823 名符合条件的淋巴结阳性乳腺癌患者,这些患者于 1984 年 2 月至 2000 年 11 月接受治疗。评估了以下因素:ECS、受累淋巴结数量、组织学肿瘤分级、肿瘤大小、雌激素和孕激素受体状态以及患者年龄。采用 Cox 比例风险法寻找与 OS 和 DFS 长度相关的显著因素。

结果

在多变量分析中,与 DFS 长度相关的因素包括:肿瘤分级(aHR 0.76,95%CI 0.61-0.96,p=0.02)、ECS 状态(aHR 0.7,95%CI 0.49-0.96,p=0.03)、孕激素受体(PgR)状态(aHR 0.63,95%CI 0.44-0.85,p=0.008)、受累淋巴结数量(aHR 0.75,95%CI 0.56-1,p=0.05)。OS 的多变量分析发现有意义的因素包括:肿瘤分级(aHR 0.76,95%CI 0.61-0.95;p=0.02)和 PgR 状态(aHR 0.8,95%CI 0.56-0.99,p=0.02)。

结论

本研究表明,在辅助决策过程中应考虑 ECS 状态。

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