Medical Oncology Department, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
Medical Oncology Department, Ankara Numune Training and Research Hospital, Turkey.
Breast Care (Basel). 2014 Dec;9(6):421-7. doi: 10.1159/000366438.
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).
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.
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).
Menopausal status, PgR status, and LNR were independent prognostic factors in operated N3a breast cancer patients, who are underrepresented in breast cancer trials.
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。
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。
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）。
在乳腺癌临床试验中代表性不足的接受手术治疗的 N3a 乳腺癌患者中，绝经状态、PgR 状态和 LNR 是独立的预后因素。
