Pandey Manjari, Sutton Gregory R, Giri Smith, Martin Mike G
Department of Medical Oncology, West Cancer Center/ University of Tennessee Health Science Center, Memphis, TN.
Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN.
Clin Breast Cancer. 2015 Aug;15(4):266-9. doi: 10.1016/j.clbc.2014.12.009. Epub 2015 Jan 3.
Primary angiosarcoma of the breast (PAOB) is rare and institutional series have provided conflicting data on the effect of grade on prognosis.
Using a case listing session of Surveillance, Epidemiology, and End Results (SEER) 18 (1973-2010) we examined outcomes for patients with PAOB. Analyses were conducted with SEER*Stat 8.1.2, Microsoft Excel 2007, and GraphPad Prism 6. Comparisons were made using the Fisher exact test and log rank test (Mantel-Cox); P values were 2-sided.
Two hundred twenty-six women with PAOB were identified; median age was 49 (range, 15-107) years and 82% (185) were white. Seventy-two percent (162) had localized disease, 15% (34) regional disease, 7% (16) distant disease, and 6% (14) had unknown staging. Fourteen percent (32) had Grade 1, 24% (55) Grade 2, 30% (68) Grade 3 disease, and grade was unknown in 32% (72) of patients. Median overall survival (OS) for patients with localized, regional, and distant disease was 172, 24, and 16 months, respectively (P < .001). Median OS for patients with localized Grade 1 and 2 disease was not reached versus 36 months for Grade 3 disease (P < .001); 3-year OS was 89% (78) versus 47% (32). There was a strong trend for patients with Grade 3 disease to undergo mastectomy (44%, n = 30 vs. 23%, n = 20; P = .070) and 24% (55) of all patients received radiation. Radiation did not improve survival for localized Grade 1 and 2 disease (P = .676), or Grade 3 disease (P = .589); surgery and grade subgroups were too small for meaningful comparisons regarding radiation.
Histologic grade is a significant predictor of survival for patients with localized PAOB. Regardless of grade, adjuvant radiation did not confer a survival benefit for patients with localized disease.
原发性乳腺血管肉瘤（PAOB）较为罕见，不同机构的研究系列对于分级对预后的影响提供了相互矛盾的数据。
利用监测、流行病学和最终结果（SEER）18数据库（1973 - 2010年）的病例列表会议，我们研究了PAOB患者的预后情况。使用SEER*Stat 8.1.2、Microsoft Excel 2007和GraphPad Prism 6进行分析。采用Fisher精确检验和对数秩检验（Mantel - Cox）进行比较；P值为双侧。
共识别出226例PAOB女性患者；中位年龄为49岁（范围15 - 107岁），82%（185例）为白人。72%（162例）为局限性疾病，15%（34例）为区域性疾病，7%（16例）为远处疾病，6%（14例）分期未知。14%（32例）为1级，24%（55例）为2级，30%（68例）为3级疾病，32%（72例）患者分级未知。局限性、区域性和远处疾病患者的中位总生存期（OS）分别为172个月、24个月和16个月（P <.001）。局限性1级和2级疾病患者的中位OS未达到，而3级疾病患者为36个月（P <.001）；3年总生存率分别为89%（78例）和47%（32例）。3级疾病患者接受乳房切除术的趋势明显（44%，n = 30对23%，n = 20；P =.070），所有患者中有24%（55例）接受了放疗。放疗对局限性1级和2级疾病患者（P =.676）或3级疾病患者（P =.589）的生存无改善；手术和分级亚组对于放疗的有意义比较来说太小。
组织学分级是局限性PAOB患者生存的重要预测因素。无论分级如何，辅助放疗对局限性疾病患者均未带来生存获益。
