Weiss Rüdiger J, Tullberg Elias, Forsberg Jonathan A, Bauer Henrik C, Wedin Rikard
Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden.
Breast. 2014 Jun;23(3):286-90. doi: 10.1016/j.breast.2014.02.012. Epub 2014 Mar 27.
The aim was to identify prognostic variables associated with survival in 301 breast cancer patients after surgical treatment of skeletal metastases. The study period was 1986-2012. The median age at surgery was 61 (interquartile-range [IQR] 52-70) years. The cumulative 1-, 2-, and 5-year survival after surgery was 45% (95% CI 39-51), 27% (22-32), and 8% (5-12), respectively. The median follow-up time was 1 (IQR 0.2-2) year. Age over 60 years (Hazard ratio [HR] 1.9) and hemoglobin levels <110 g/L (HR 2) increased the risk of death after surgery. Patients with impending fractures (HR 0.4) had a lower death rate. The overall neurological function in patients with spinal metastases improved after surgery (p < 0.001). The complication rate was 25%, including 14% re-operations. Survival data and analysis of complications of this large cohort of surgically treated breast cancer patients help to set appropriate expectations for the patients, families, and medical staff.
目的是确定301例接受骨骼转移瘤手术治疗的乳腺癌患者的生存相关预后变量。研究时间段为1986年至2012年。手术时的中位年龄为61岁（四分位间距[IQR]52 - 70岁）。术后1年、2年和5年的累积生存率分别为45%（95%置信区间39 - 51）、27%（22 - 32）和8%（5 - 12）。中位随访时间为1年（IQR 0.2 - 2年）。60岁以上（风险比[HR]1.9）和血红蛋白水平<110 g/L（HR 2）会增加术后死亡风险。有即将发生骨折的患者（HR 0.4）死亡率较低。脊柱转移患者术后的整体神经功能有所改善（p < 0.001）。并发症发生率为25%，其中再次手术率为14%。这一大群接受手术治疗的乳腺癌患者的生存数据及并发症分析有助于为患者、家属和医护人员设定合理的预期。
