Chairat Rungnapa, Puttisri Adisom, Pamarapa Asani, Wongrach Nongnoot, Tawichasri Chamaiporn, Patumanond Jayanton, Tantraworasin Apichat, Charoentum Chaiyut
J Med Assoc Thai. 2014 Sep;97(9):932-8.
To describe the pattern of disease progression and to describe locoregional recurrence, distant recurrence, and death rates in breast cancer patients after complete treatment.
Medical records of women diagnosed with breast cancer at two university affiliated tertiary care hospitals in the Northern Thailand that had complete treatments between 2006 and 2010 were traced. Extracted key information included patient clinical profiles and documented recurrence of cancer The causes of death were verified from breast cancer case registration database, death certificates through The Ministry of Internal Affairs'civil registration, by direct telephone contact, or by distributed prepaid postcards.
Medical records of 829 women diagnosed with breast cancer without prior evidence ofdistant metastasis, and had complete recommended treatment were included. Six hundred thirty seven women had not experienced any events up to the end of the follow-up (76.8%). The first occurring events were focused and categorized into three distinct types, locoregional recurrence (n = 83, median follow-up time = 34.2 months), distant recurrence (n = 78, median follow-up time = 35.4 months), and death without any evidences of locoregional or distant recurrences (n = 12, median follow-up time = 36.7 months). Distant recurrence after locoregional recurrence was reported (n = 33). There were 109 patient who had died (breast cancer related death) up to the end of the follow-up (13.2%). The three types of consecutively occurring deaths were death after locoregional recurrence without any distant recurrences (n = 15), death after distant recurrence with locoregional recurrence (n = 21), and death after documenited distant recurrence without any locoregional recurrences (n = 61).
The trend was that the rate of the first occurring locoregional recurrence was slightly higher than that of distant recurrence, The death rate in patients without any recurrences was much lower than in those experiencing prior recurrences. The rates of disease progression from local recurrence to distant recurrence and to death were approximately 5 to 7 times faster in patients who had experienced earlierprogressions.
描述疾病进展模式，并描述乳腺癌患者在接受完整治疗后的局部区域复发、远处复发及死亡率。
追溯泰国北部两所大学附属三级护理医院2006年至2010年间确诊为乳腺癌且接受了完整治疗的女性患者的病历。提取的关键信息包括患者临床资料及记录的癌症复发情况。通过乳腺癌病例登记数据库、内政部民事登记处的死亡证明、直接电话联系或发放预付明信片等方式核实死亡原因。
纳入829例诊断为乳腺癌且无远处转移先前证据并接受了完整推荐治疗的女性患者的病历。637例女性在随访结束时未发生任何事件（76.8%）。首次发生的事件集中并分为三种不同类型，即局部区域复发（n = 83，中位随访时间 = 34.2个月）、远处复发（n = 78，中位随访时间 = 35.4个月）以及无局部区域或远处复发证据的死亡（n = 12，中位随访时间 = 36.7个月）。报告了局部区域复发后的远处复发（n = 33）。随访结束时共有109例患者死亡（与乳腺癌相关的死亡）（13.2%）。连续发生的三种死亡类型分别为局部区域复发后无远处复发的死亡（n = 15）、远处复发伴局部区域复发后的死亡（n = 21）以及记录的远处复发后无局部区域复发的死亡（n = 61）。
趋势是首次发生的局部区域复发率略高于远处复发率，无任何复发患者的死亡率远低于有先前复发患者的死亡率。在经历过早期进展的患者中，疾病从局部复发进展到远处复发再到死亡的速度大约快5至7倍。
