Department of Medical Oncology, University Hospital of Besancon, Besançon, France.
Int J Clin Oncol. 2013 Aug;18(4):607-13. doi: 10.1007/s10147-012-0439-z. Epub 2012 Jul 5.
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).
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.
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).
This study might suggest taking into account ECS status in the adjuvant decision-making process.
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。
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。
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)。
本研究表明,在辅助决策过程中应考虑 ECS 状态。