Department of Surgical Oncology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
World J Surg Oncol. 2018 Aug 14;16(1):169. doi: 10.1186/s12957-018-1472-9.
According to the Response Evaluation Criteria in Solid Tumors (RECIST), progressive disease (PD) is diagnosed under two conditions: an increase in size of pre-existing lesions (IS) and the appearance of new lesions (NL). We retrospectively investigated the difference in the prognosis between IS and NL.
Patients receiving drug therapies for metastatic breast cancer between 2004 and 2015 at our institution were reviewed. The survival time after NL and IS was compared and the frequency of NL with each drug calculated.
For the 107 eligible patients, the survival time after NL at second-line chemotherapy was significantly worse than after IS (median survival time 4.3 months vs. 20.3 months, p = 0.0048). Maintenance therapy with bevacizumab or trastuzumab had a high frequency of NL (88.9%), and third-line eribulin had a low frequency of NL (16.7%). A multivariate analysis showed that NL at second-line chemotherapy was not an independent risk factor (hazard ratio 1.02, 95%; confidence interval 0.54-1.93, p = 0.95) for the total survival time.
Patients with IS had a better survival after PD than those with NL. We may be able to avoid changing drug therapy for patients without NL and allow them to continue drug therapy for longer.
根据实体瘤反应评价标准（RECIST），在两种情况下诊断为疾病进展（PD）：先前存在的病变（IS）增大和新病变（NL）出现。我们回顾性研究了 IS 和 NL 之间预后的差异。
我们回顾了 2004 年至 2015 年在我院接受转移性乳腺癌药物治疗的患者。比较了 NL 和 IS 后患者的生存时间，并计算了每种药物的 NL 频率。
对于 107 例合格患者，二线化疗后 NL 的生存时间明显差于 IS（中位生存时间 4.3 个月比 20.3 个月，p = 0.0048）。贝伐珠单抗或曲妥珠单抗维持治疗 NL 发生率高（88.9%），三线厄瑞替尼 NL 发生率低（16.7%）。多因素分析显示，二线化疗时 NL 不是总生存时间的独立危险因素（危险比 1.02，95%；置信区间 0.54-1.93，p = 0.95）。
与 NL 患者相比，IS 患者 PD 后生存更好。我们或许可以避免对没有 NL 的患者改变药物治疗，并让他们继续更长时间的药物治疗。
