Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
Department of Oncology and Pathology, Karolinska University Hospital, CCK, R8:03, 17176, Stockholm, Sweden.
Breast Cancer Res Treat. 2018 Dec;172(3):703-712. doi: 10.1007/s10549-018-4936-2. Epub 2018 Sep 17.
Survival after loco-regional failure (LRF) of breast cancer was investigated at the population level.
Using the Stockholm cancer registry, 2698 patients diagnosed with LRF between 1980 and 2014 were identified and divided into three cohorts by year of LRF diagnosis. Post-relapse event-free survival (EFS) and overall survival (OS) were analyzed separately in local and loco-regional relapses and compared across the cohorts by Kaplan-Meier method. Relative survival was estimated and Poisson regression models, adjusted for clinically relevant prognostic factors, were fitted for excess mortality ratio calculation. Age-related survival trends were also explored.
Among 1922 patients diagnosed with local relapse, 1032 (54%) EFS events and 931 (48%) deaths were registered. A significant improvement in EFS (p < 0.001) and OS (p < 0.001) was demonstrated in tumors that recurred locally in the years 1990-1999 and 2000-2014 compared with 1980-1989, regardless of age at relapse (≤ 60 years; > 60 years). In women with loco-regional relapse, 557 out of 776 (72%) experienced a post-relapse event and 522 (67%) died. Significantly longer EFS and OS were seen over time in the whole group (p < 0.001 and p = 0.003, respectively) and in younger (p < 0.001; p < 0.001) but not in older women (p = 0.55; p = 0.80). Relative survival was consistent with OS and a statistically significant decrease in mortality after loco-regional recurrence over time was seen only in women aged ≤ 60 years.
Survival after loco-regional failure of breast cancer has improved over time, especially in younger women.
在人群水平上研究了乳腺癌局部区域复发（LRF）后的生存情况。
使用斯德哥尔摩癌症登记处，确定了 1980 年至 2014 年间诊断为 LRF 的 2698 例患者，并按 LRF 诊断年份分为三个队列。分别分析局部和局部区域复发后的无复发生存（EFS）和总生存（OS），并通过 Kaplan-Meier 方法比较各队列之间的差异。还估计了相对生存率，并拟合了调整了临床相关预后因素的泊松回归模型，以计算超额死亡率比。还探讨了与年龄相关的生存趋势。
在 1922 例诊断为局部复发的患者中，登记了 1032 例（54%）EFS 事件和 931 例（48%）死亡。与 1980-1989 年相比，1990-1999 年和 2000-2014 年局部复发的肿瘤 EFS（p<0.001）和 OS（p<0.001）显著改善，无论复发时的年龄（≤60 岁；>60 岁）如何。在局部区域复发的 776 例女性中，557 例（72%）发生了复发后事件，522 例（67%）死亡。整个组（p<0.001 和 p=0.003）和较年轻的女性（p<0.001；p<0.001）的 EFS 和 OS 随时间推移显著延长，但较年长的女性则不然（p=0.55；p=0.80）。相对生存率与 OS 一致，仅在≤60 岁的女性中，随着时间的推移，局部区域复发后的死亡率呈统计学显著下降。
乳腺癌局部区域复发后的生存情况已得到改善，尤其是在较年轻的女性中。
