Li Mingzhu, Chen Kai, Liu Fengtao, Su Fengxi, Li Shunrong, Zhu Liling
Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
PLoS One. 2017 Aug 25;12(8):e0183448. doi: 10.1371/journal.pone.0183448. eCollection 2017.
To determine the prevalence of nipple-sparing mastectomy (NSM) and its long-term survival outcomes in breast cancer patients.
We used the Surveillance, Epidemiology, and End Results database and identified 2,440 breast cancer patients who received NSM during 1998-2013. We used chi-square and binary logistic regression to identify factors associated with the use of radiotherapy after NSM. We used Kaplan-Meier analysis to estimate cancer-specific survival (CSS) and overall survival (OS). We used the log-rank test and Cox regression to identify factors associated with CSS and OS.
The median age of the population was 50 years. There were 725 (29.7%), 1064 (43.6%) and 651 (26.7%) patients who had Tis, T1 and T2-3 disease and 1943 (79.6%), 401 (16.4%) and 96 (3.9%) patients who had N0, N1 and N2-3 disease, respectively. The rates of RT use were 61.4%, 39.6% and 10.9% in patients with N2-3 disease, N1 or T3/N0 disease and Tis/T1-2N0 disease, respectively. Elderly age, African American race, and higher T-stage and N-stage were associated with receiving radiotherapy. For patients diagnosed between 1998-2010 (N = 763), the median follow-up was 69 months. The 5- and 10-yr CSS were 96.9% and 94.9%, respectively. The 5- and 10-yr OS were 94.1% and 88.0%, respectively. Ethnicity, T-stage and N-stage were factors independently associated with CSS, and age and T-stage were factors independently associated with OS.
The use of NSM has increased, and it is oncologically safe for breast cancer patients.
确定保乳根治术（NSM）在乳腺癌患者中的应用率及其长期生存结局。
我们使用监测、流行病学和最终结果数据库，识别出1998年至2013年间接受NSM的2440例乳腺癌患者。我们使用卡方检验和二元逻辑回归来确定与NSM后放疗使用相关的因素。我们使用Kaplan-Meier分析来估计癌症特异性生存（CSS）和总生存（OS）。我们使用对数秩检验和Cox回归来确定与CSS和OS相关的因素。
人群的中位年龄为50岁。分别有725例（29.7%）、1064例（43.6%）和651例（26.7%）患者患有Tis、T1和T2-3期疾病，以及1943例（79.6%）、401例（16.4%）和96例（3.9%）患者患有N0、N1和N2-3期疾病。N2-3期疾病、N1或T3/N0期疾病以及Tis/T1-2N0期疾病患者的放疗使用率分别为61.4%、39.6%和10.9%。老年、非裔美国人种族以及更高的T分期和N分期与接受放疗相关。对于1998年至2010年期间诊断的患者（N = 763），中位随访时间为69个月。5年和10年的CSS分别为96.9%和94.9%。5年和10年的OS分别为94.1%和88.0%。种族、T分期和N分期是与CSS独立相关的因素，年龄和T分期是与OS独立相关的因素。
NSM的应用有所增加，对乳腺癌患者在肿瘤学上是安全的。
