Choi W J, Cha J H, Kim H H, Shin H J, Chae E Y, Jung K H, Ahn J-H, Kim S-B, Son B H, Ahn S H
Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Clin Oncol (R Coll Radiol). 2017 Oct;29(10):653-661. doi: 10.1016/j.clon.2017.06.015. Epub 2017 Jul 17.
To investigate whether preoperative magnetic resonance imaging (MRI) in patients with primary breast cancer is predictive of disease-free (DFS) and overall survival and to determine the prognostic factors indicating survival.
This retrospective study was approved by the institutional review board and the requirement for informed consent was waived. From 2009 to 2010, 828 women with primary breast cancer and preoperative MRI were matched with 1613 women without such imaging. Patients were matched with regards to 25 patient and tumour-related covariates. A Cox proportional hazards model was used to investigate the time to recurrence and to estimate the hazard ratio for preoperative MRI. Log-rank tests and Cox proportional hazards survival analysis were carried out on total recurrence DFS and overall survival in the unmatched datasets.
In total, 799 matched pairs were available for survival analysis. The MRI group showed a tendency towards better survival outcome; however, there were no significant differences in DFS and overall survival. Age at diagnosis (DFS hazard ratio = 0.98; overall survival hazard ratio = 1.04), larger tumour size (DFS hazard ratio = 1.01; overall survival hazard ratio = 1.02), triple negative breast cancer (DFS hazard ratio = 2.64; overall survival hazard ratio = 3.44) and the presence of lymphovascular invasion (DFS hazard ratio = 2.12; overall survival hazard ratio = 2.70) were independent significant variables for worse DFS and overall survival.
Preoperative MRI did not result in an improvement in a patient's outcome. Age at diagnosis, tumour size, molecular subtype and lymphovascular invasion were significant independent factors affecting both DFS and overall survival.
研究原发性乳腺癌患者术前磁共振成像（MRI）是否可预测无病生存期（DFS）和总生存期，并确定提示生存的预后因素。
本回顾性研究经机构审查委员会批准，无需知情同意。2009年至2010年，828例有术前MRI的原发性乳腺癌女性与1613例无此类影像检查的女性进行匹配。患者在25项患者和肿瘤相关协变量方面进行匹配。采用Cox比例风险模型研究复发时间，并估计术前MRI的风险比。对未匹配数据集中的总复发DFS和总生存期进行对数秩检验和Cox比例风险生存分析。
总共799对匹配数据可用于生存分析。MRI组显示出更好生存结局的趋势；然而，DFS和总生存期无显著差异。诊断时年龄（DFS风险比=0.98；总生存期风险比=1.04）、肿瘤较大（DFS风险比=1.01；总生存期风险比=1.02）、三阴性乳腺癌（DFS风险比=2.64；总生存期风险比=3.44）和存在淋巴管浸润（DFS风险比=2.12；总生存期风险比=2.70）是DFS和总生存期较差的独立显著变量。
术前MRI并未改善患者预后。诊断时年龄、肿瘤大小、分子亚型和淋巴管浸润是影响DFS和总生存期的重要独立因素。
