Kim Haeyoung, Choi Doo Ho, Park Won, Huh Seung Jae, Nam Seok Jin, Lee Jeong Eon, Ahn Jin Seok, Im Young-Hyuck
Department of Radiation Oncology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Radiat Oncol J. 2013 Dec;31(4):222-7. doi: 10.3857/roj.2013.31.4.222. Epub 2013 Dec 31.
This study was performed to evaluate prognostic factors for survival from first relapse (SFFR) in stage I-III breast cancer patients.
From June 1994 to June 2008, 3,835 patients were treated with surgery plus postoperative radiotherapy and adjuvant chemotherapy for stage I-III breast cancer at Samsung Medical Center. Among them, a total of 224 patients died by June 2009, and 175 deaths were of breast cancer. Retrospective review was performed on medical records of 165 patients who met the inclusion criteria of this study. Univariate and multivariate analysis were done on survivals according to variables, such as age, stage, hormone status of tumor, disease-free interval (DFI), sites of first failure, number of organs involved by recurrent disease (NOR), application of salvage treatments, and existence of brain or liver metastasis (visceral metastasis).
Patients' median overall survival time was 38 months (range, 8 to 123 months). Median SFFR was 17 months (range, 5 to 87 months). Ninety percent of deaths occurred within 40 months after first recurrence. The patients with SFFR ≤1 year had tendency of triple-negativity, shorter DFI (≤2 years), larger NOR (>3), visceral metastasis for first relapse than the patients with SFFR >1 year. In multivariate analysis, longer DFI (>2 vs. ≤2 years), absence of visceral metastasis, and application of salvage treatments were statistically significant prognosticators for longer SFFR.
The DFI, application of salvage treatments, and visceral metastasis were significant prognostic factors for SFFR in breast cancer patients.
本研究旨在评估Ⅰ-Ⅲ期乳腺癌患者首次复发后的生存预后因素(SFFR)。
1994年6月至2008年6月,三星医疗中心对3835例Ⅰ-Ⅲ期乳腺癌患者进行了手术加术后放疗及辅助化疗。其中,截至2009年6月共有224例患者死亡,175例死于乳腺癌。对符合本研究纳入标准的165例患者的病历进行回顾性分析。根据年龄、分期、肿瘤激素状态、无病间期(DFI)、首次复发部位、复发疾病累及器官数量(NOR)、挽救性治疗的应用以及脑或肝转移(内脏转移)等变量对生存率进行单因素和多因素分析。
患者的中位总生存时间为38个月(范围8至123个月)。中位SFFR为17个月(范围5至87个月)。90%的死亡发生在首次复发后的40个月内。SFFR≤1年的患者与SFFR>1年的患者相比,有三阴性倾向、DFI较短(≤2年)、NOR较大(>3)、首次复发时有内脏转移。在多因素分析中,较长的DFI(>2年与≤2年)、无内脏转移以及应用挽救性治疗是SFFR较长的统计学显著预后因素。
DFI、挽救性治疗的应用以及内脏转移是乳腺癌患者SFFR的重要预后因素。