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乳腺癌患者预后因素及无复发生存情况的调查

Investigation of Prognostic Factors and Survival without Recurrence in Patients with Breast Cancer.

作者信息

Abdollahi Ahmad, Zadeh Hamzeh Saleh, Akbari Mojtaba, Tahmasbi Sedigheh, Talei Abdolrasoul, Hassanzadeh Jafar

机构信息

Department of General Surgery, School of Medicine, Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Adv Biomed Res. 2017 Apr 17;6:42. doi: 10.4103/2277-9175.204595. eCollection 2017.

Abstract

BACKGROUND

One of the major consequences of breast cancer is the recurrence of the disease. The objective of present study was to estimate the 7-year survival without recurrence as well as the effective prognostic factors in recurrence.

MATERIALS AND METHODS

This historical cohort survival analysis was conducted on 1329 patients diagnosed with breast cancer in Motahari Breast Clinic, Shiraz, Iran between 2004 and 2011. We estimated the rate of survival without recurrence through the Kaplan-Meier method and the difference between the survival curves was investigated using the log-rank test. Furthermore, Cox regression model was used to model the effective factors in local recurrence as well as metastasis.

RESULTS

The mean age of the patients was 54.8 ± 11.4 years. Estrogen receptor positive, progesterone receptor positive, and human epidermal growth factor receptor-2 positive were observed in 70.6%, 66.6%, and 34.4% of the cases, respectively. The mean of the follow-up period was 3.7 ± 1.8 years in all patients. The results of the Kaplan-Meier method revealed 1-, 3-, 5-, and 7-year rate of survival without recurrence as 96.4%, 78.4%, 66.3%, and 54.8%, respectively. There was a significant relationship between survival without recurrence and histology grade (hazard ratio [HR] = 1.66, = 0.009), neural invasion (HR = 1.74, = 0.006), and progesterone receptors (HR = 0.69, = 0.031).

CONCLUSION

In this study, the rate of survival without recurrence in breast cancer was 54.8%. Among factors, histology grade and neural involvement at the time of diagnosis increased the chance of recurrence and progesterone receptors caused a longer interval between diagnosis and recurrence.

摘要

背景

乳腺癌的主要后果之一是疾病复发。本研究的目的是估计7年无复发生存率以及复发的有效预后因素。

材料与方法

对2004年至2011年期间在伊朗设拉子莫塔哈里乳腺诊所诊断为乳腺癌的1329例患者进行了这项历史性队列生存分析。我们通过Kaplan-Meier方法估计无复发生存率,并使用对数秩检验研究生存曲线之间的差异。此外,使用Cox回归模型对局部复发和转移的有效因素进行建模。

结果

患者的平均年龄为54.8±11.4岁。分别在70.6%、66.6%和34.4%的病例中观察到雌激素受体阳性、孕激素受体阳性和人表皮生长因子受体2阳性。所有患者的平均随访期为3.7±1.8年。Kaplan-Meier方法的结果显示,1年、3年、5年和7年无复发生存率分别为96.4%、78.4%、66.3%和54.8%。无复发生存与组织学分级(风险比[HR]=1.66,P=0.009)、神经侵犯(HR=1.74,P=0.006)和孕激素受体(HR=0.69,P=0.031)之间存在显著关系。

结论

在本研究中,乳腺癌无复发生存率为54.8%。在这些因素中,诊断时的组织学分级和神经受累增加了复发的机会,而孕激素受体导致诊断与复发之间的间隔更长。

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本文引用的文献

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Residual risk of breast cancer recurrence 5 years after adjuvant therapy.辅助治疗后5年乳腺癌复发的残留风险。
J Natl Cancer Inst. 2008 Aug 20;100(16):1179-83. doi: 10.1093/jnci/djn233. Epub 2008 Aug 11.

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