Akbari Mohammad Esmaeil, Rohani- Rasaf Marzieh, Nafissi Nahid, Akbari Atieh, Shojaee Leyla
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Email:
Asian Pac J Cancer Prev. 2018 Apr 25;19(4):949-953. doi: 10.22034/APJCP.2018.19.4.949.
Background: Recurrence of breast cancer after treatment is generally due to loco-regional invasion or distant metastasis. Although patients with metastasis are considered incurable, existing treatments might prolong a patient’s life while also improving its quality. Choice of approach for individual patients requires identification of relevant survival factors. This study concerns factors influencing survival after recurrence in Iranian breast cancer patients. Methods: This study was performed on 442 recurrent breast cancer patients referred to the Cancer Research Center of Shahid Beheshti University between 1985 and 2015. After confirming recurrence as a distant metastasis or loco-regional invasion, the effects of demographic, clinic-pathologic, biological, type of surgery and type of adjuvant treatment on survival were evaluated using univariate and multivariate stratified Cox models. Results: The mean survival after recurrence was 18 months (5 days to 13 years), 219 patients (70.42%) survived two years, 75 patients (24.12%) survived from 2 to 5 years, and 17 patients (5.47%) survived more than 5 years. In this study, it was found through univariate analysis that the factors of age, lymph node status, DFI, place of recurrence and nodal ratio demonstrated greatest influence on survival after recurrence. On multivariate analysis, the most important factors influencing survival were the place of recurrence and the lymph node status. Conclusion: The results of this study enhance our knowledge of effects of different factors on survival of patients after breast cancer recurrence. Thus, they may be used to inform treatment choice.
乳腺癌治疗后的复发通常是由于局部区域侵犯或远处转移。尽管发生转移的患者被认为无法治愈,但现有治疗方法可能会延长患者生命并提高其生活质量。为个体患者选择治疗方法需要确定相关的生存因素。本研究关注影响伊朗乳腺癌患者复发后生存的因素。
本研究对1985年至2015年间转诊至沙希德·贝赫什提大学癌症研究中心的442例复发性乳腺癌患者进行。在确认复发为远处转移或局部区域侵犯后,使用单变量和多变量分层Cox模型评估人口统计学、临床病理、生物学、手术类型和辅助治疗类型对生存的影响。
复发后的平均生存期为18个月(5天至13年),219例患者(70.42%)存活两年,75例患者(24.12%)存活2至5年,17例患者(5.47%)存活超过5年。在本研究中,通过单变量分析发现年龄、淋巴结状态、无病间期、复发部位和淋巴结比率等因素对复发后的生存影响最大。多变量分析显示,影响生存的最重要因素是复发部位和淋巴结状态。
本研究结果增进了我们对不同因素对乳腺癌复发后患者生存影响的了解。因此,它们可用于指导治疗选择。