El Saghir Nagi S, Assi Hussein A, Jaber Sara M, Khoury Katia E, Nachef Zahi, Mikdashi Hana F, El-Asmar Nadine S, Eid Toufic A
1. Breast Center of Excellence, Naef K. Basile Cancer Institute and Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon;
2. Naef K. Basile Cancer Institute and Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon.
J Cancer. 2014 Jun 3;5(6):491-8. doi: 10.7150/jca.9216. eCollection 2014.
Information on outcome of breast cancer patients treated in the community is scarce. Data on outcome of patients treated in real-life clinical practice may provide useful information for performance improvement.
Study population is from a single institution practice at the American University of Beirut Medical Center. Demographics, clinical characteristics and survival data on patients diagnosed 1997-2010 in two IRB-approved studies were entered and analyzed on SPSS program. Survival was estimated using Kaplan Meier Method.
Total was 519 patients. 23.9% had stage I, 39.7% stage II, 30.4% Stage III and 6% stage IV. ER positive in 74.4% of patients. 30.6% of patients <35 had TNBC compared to 12.3% for the whole group. 45.9% of non-metastatic patients had breast-conserving therapy (BCT). BCT rates increased to 64% during the second half of the study, coinciding with increasing awareness and changing cultural mores. 5-year and 10-year overall survivals for stage I were 98.9% and 80.5%, 89.2% and 70.7% for stage II, 67.6% and 35.5% for stage III, and 39.1% and 26.1% for stage IV respectively.
Patients treated outside clinical trials in a multidisciplinary fashion according to guidelines have comparable, and at times better, survival compared to data from trials or population statistics. Locally generated outcome data could be valuable for evaluating results of treatment at individual practices for the purpose of quality assessment and improvement. Our data also provides report of increased rate of breast conserving surgery from Middle East.
关于社区中乳腺癌患者治疗结果的信息匮乏。现实临床实践中患者治疗结果的数据可能为改善医疗服务提供有用信息。
研究人群来自贝鲁特美国大学医疗中心的单一机构实践。将1997年至2010年在两项经机构审查委员会批准的研究中确诊患者的人口统计学、临床特征和生存数据录入SPSS程序并进行分析。采用Kaplan-Meier方法估计生存率。
共有519例患者。23.9%为I期，39.7%为II期，30.4%为III期，6%为IV期。74.4%的患者雌激素受体阳性。年龄<35岁的患者中30.6%为三阴性乳腺癌，而整个研究组这一比例为12.3%。45.9%的非转移性患者接受了保乳治疗（BCT）。在研究的后半期，保乳治疗率增至64%，这与认知度提高和文化观念转变相吻合。I期患者的5年和10年总生存率分别为98.9%和80.5%，II期分别为89.2%和70.7%，III期分别为67.6%和35.5%，IV期分别为39.1%和26.1%。
根据指南以多学科方式在临床试验之外接受治疗的患者，其生存率与试验数据或总体统计数据相当，有时甚至更好。本地生成的结果数据对于评估个体医疗机构的治疗结果以进行质量评估和改进可能很有价值。我们的数据还提供了中东地区保乳手术率上升的报告。
