Fung Filgen, Cornacchi Sylvie D, Vanniyasingam Thuva, Dao Dyda, Thabane Lehana, Simunovic Marko, Hodgson Nicole, O'Brien Mary Ann, Reid Susan, Heller Barbara, Lovrics Peter J
Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.
Department of Clinical Epidemiology and Biostatistics, McMaster University and Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
Am J Surg. 2017 Feb;213(2):418-425. doi: 10.1016/j.amjsurg.2016.03.016. Epub 2016 Jun 14.
The study purpose was to identify tumor and surgeon predictors of local recurrence (LR), regional recurrence (RR), and distant metastasis (DM) after breast cancer (BC) surgery in a population-based cohort.
Consecutive BC surgical cases from 12 hospitals in South Central Ontario between May 2006 and October 2006 were included. Data collected on chart review included patient and tumor factors, surgery type, adjuvant treatment, surgeon specialty, surgeon case volume, and practice type. Univariate and multivariable survival analyses were performed.
Median follow-up was 5.5 years for 402 patients (97% of sample). LR, RR, and DM occurred in 18 (4.5%), 10 (2.5%), and 47 (12%) patients, respectively. Significant predictors of BC recurrence (LR or RR or DM) were tumor size and grade, nodal status, and lymphovascular invasion on multivariable analysis.
Tumor factors such as size, grade, lymphovascular invasion, and nodal status predicted BC recurrence, while practice type, surgeon specialty, and case volume did not.
本研究目的是在一个基于人群的队列中确定乳腺癌（BC）手术后局部复发（LR）、区域复发（RR）和远处转移（DM）的肿瘤及外科医生预测因素。
纳入2006年5月至2006年10月间安大略省中南部12家医院连续的BC手术病例。通过病历审查收集的数据包括患者和肿瘤因素、手术类型、辅助治疗、外科医生专业、外科医生手术量及执业类型。进行单变量和多变量生存分析。
402例患者（占样本的97%）的中位随访时间为5.5年。LR、RR和DM分别发生在18例（4.5%）、10例（2.5%）和47例（12%）患者中。多变量分析显示，BC复发（LR或RR或DM）的显著预测因素为肿瘤大小和分级、淋巴结状态及淋巴管浸润。
肿瘤大小、分级、淋巴管浸润及淋巴结状态等肿瘤因素可预测BC复发，而执业类型、外科医生专业及手术量则不能。
