手术治疗 IIIC 期、病理 N3a 乳腺癌患者的预后因素。

Prognostic Factors in Operated Stage IIIC, Pathological N3a Breast Cancer Patients.

机构信息

Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.

Medical Oncology Department, Ankara Numune Training and Research Hospital, Turkey.

出版信息

Breast Care (Basel). 2014 Dec;9(6):421-7. doi: 10.1159/000366438.

DOI:10.1159/000366438

PMID:25759625

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4317680/

Abstract

BACKGROUND

The aim of this retrospective study was to evaluate the prognostic factors in patients operated for stage IIIC breast carcinoma who had > 10 positive axillary lymph nodes (pN3a).

PATIENTS AND METHODS

The medical records of 302 operated N3a breast cancer patients without distant metastasis followed up in 2 medical oncology clinics in Ankara between January 1998 and June 2013 were evaluated retrospectively.

RESULTS

The median age was 50 (21-83) years. The median follow-up time was 43 (5-191) months. The patients were divided into 4 subgroups according to hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 151 (50.0%) patients in the HR+/HER2- group, 80 (26.5%) patients in the HR+/HER2+ group, 42 (13.9%) patients in the HR-/HER2+ group, and 29 (9.6%) patients in the triple negative (TN) group. At the time of analysis, 155 (51.3%) patients had recurrent disease and 117 (38.7%) patients had died. The median disease-free survival (DFS) and overall survival (OS) times were 46.0 and 78.0 months, respectively. Both the DFS and OS in the HR+/HER2- group were longer than in the other groups (log-rank p = 0.034 and p = 0.016, respectively). Menopausal status, progesterone receptor (PgR) status, and lymph node ratio (LNR; defined as the number of positive lymph nodes compared to the total number of removed lymph nodes) were found to be independent prognostic factors (p = 0.019, p = 0.001, and p = 0.012, respectively).

CONCLUSION

Menopausal status, PgR status, and LNR were independent prognostic factors in operated N3a breast cancer patients, who are underrepresented in breast cancer trials.

摘要

背景

本回顾性研究旨在评估接受手术治疗的 IIIC 期乳腺癌患者（腋窝淋巴结转移>10 个，pN3a）的预后因素。

方法

回顾性分析 1998 年 1 月至 2013 年 6 月在安卡拉的 2 家医学肿瘤学诊所接受治疗且无远处转移的 302 例 N3a 乳腺癌患者的病历资料。

结果

中位年龄为 50 岁（21-83 岁）。中位随访时间为 43 个月（5-191 个月）。根据激素受体（HR）和人表皮生长因子受体 2（HER2）状态，患者分为 4 个亚组。HR+/HER2-组 151 例（50.0%），HR+/HER2+组 80 例（26.5%），HR-/HER2+组 42 例（13.9%），三阴性（TN）组 29 例（9.6%）。分析时，155 例（51.3%）患者出现疾病复发，117 例（38.7%）患者死亡。中位无病生存（DFS）和总生存（OS）时间分别为 46.0 个月和 78.0 个月。HR+/HER2-组的 DFS 和 OS 均长于其他组（对数秩检验，p = 0.034 和 p = 0.016）。绝经状态、孕激素受体（PgR）状态和淋巴结比值（LNR；定义为阳性淋巴结数与切除淋巴结总数之比）被确定为独立的预后因素（p = 0.019、p = 0.001 和 p = 0.012）。