Lee Sae Byul, Sohn Guiyun, Kim Jisun, Chung Il Yong, Kim Hee Jeong, Ko Beom Seok, Lee Jong Won, Son Byung Ho, Kim Sung-Bae, Ahn Sei-Hyun
Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Breast Cancer. 2018 Mar;21(1):70-79. doi: 10.4048/jbc.2018.21.1.70. Epub 2018 Mar 23.
This study aimed to chronologically evaluate survival of patients with breast cancer in Korea and investigate the observed changes during the last 20 years. We also sought to determine factors that may influence outcomes and changes in the duration of survival over time.
We retrospectively analyzed a total of 10,988 patients with breast cancer who were treated at our institution between January 1993 and December 2008. We divided the study period into three periods (P1, 1993-1997; P2, 1998-2002; and P3, 2003-2008). We retrospectively reviewed the collected data from the Asan database, including age at diagnosis, clinical manifestations, pathology report, surgical methods, types of adjuvant treatment modalities, type of recurrence, and follow-up period.
At a median follow-up of 8.2 years, we observed that survival outcomes have improved recently. The 5-year breast cancer-specific survival (BCSS) rate also increased from 82.8% in P1 to 92.6% in P3 (<0.001). The survival rate in patients with tumors at each stage increased in similar patterns in all patients, and, remarkably, there was a significant survival improvement in patients with stage III breast cancer (P1 vs. P3: 5-year BCSS, 57.4% vs. 80.0%, <0.001). The time period was a significant prognostic factor in multivariate analysis (P1 vs. P2: hazard ratio [HR], 0.83, =0.035; P1 vs. P3: HR, 0.75, =0.015).
The study results suggest an improvement in breast cancer survival in Korea, which is consistent with the development of treatments and early detection.
本研究旨在按时间顺序评估韩国乳腺癌患者的生存率,并调查过去20年中观察到的变化。我们还试图确定可能影响生存结果以及生存时间随时间变化的因素。
我们回顾性分析了1993年1月至2008年12月期间在我院接受治疗的总共10988例乳腺癌患者。我们将研究期分为三个阶段(P1,1993 - 1997年;P2,1998 - 2002年;P3,2003 - 2008年)。我们回顾性审查了从峨山数据库收集的数据,包括诊断时的年龄、临床表现、病理报告、手术方法、辅助治疗方式类型、复发类型和随访期。
在中位随访8.2年时,我们观察到近期生存结果有所改善。5年乳腺癌特异性生存率(BCSS)也从P1期的82.8%提高到P3期的92.6%(<0.001)。所有患者中各阶段肿瘤患者的生存率均以相似模式提高,并且,值得注意的是,III期乳腺癌患者的生存率有显著提高(P1期与P3期:5年BCSS,57.4%对80.0%,<0.001)。在多变量分析中,时间段是一个显著的预后因素(P1期与P2期:风险比[HR],0.83,P = 0.035;P1期与P3期:HR,0.75,P = 0.015)。
研究结果表明韩国乳腺癌生存率有所提高,这与治疗的发展和早期检测相一致。