评估伊朗单中心研究中三阴性乳腺癌患者的预后因素、生存和复发发生率。
Assessing the prognostic factors, survival, and recurrence incidence of triple negative breast cancer patients, a single center study in Iran.
机构信息
Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Deptartment of Biostatistics and Epidemiology, Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
PLoS One. 2019 Jan 4;14(1):e0208701. doi: 10.1371/journal.pone.0208701. eCollection 2019.
BACKGROUND
Breast cancer is the second leading cause of death due to cancer in women. Triple negative breast cancer (TNBC) is a subgroup with unique behavior. There is a controversy in organ involvement in metastasis. In this study, we planned to define the prognostic factors, survival, and recurrence incidence of patients.
MATERIALS AND METHOD
Among the 583 patients with breast mass referred to hematology and oncology clinic in Shariati hospital, Tehran, Iran from March 2005 to March 2015, fifty four patients entered the survival analysis whom we followed for two years until March 2017. Overall survival (OS) and disease-free survival (DFS) and Cumulative recurrence incidences (RI) were estimated. Univariate and multivariate Cox proportional hazards regression was performed to assess risk factors in predicting OS and DFS.
RESULTS
Median follow up for the patients was 5.00 years. The five-year OS, DFS and RI were 86.13% (95% CI (71.42-93.59), 63.09% (95% CI (47.04-75.49) and 32.15% (95% CI (19.52-47.43) respectively. Among the factors studied OS, DFS and RI differed significantly only between patients with and without nodal involvement (P = 0.004, P = 0.003, and P = 0.02 respectively). On the other hand, based on the univariate modeling, patients with nodal involvement had a higher risk of breast cancer-specific death (HR: 17.99, P = 0.004). Furthermore, patients with nodal involvement had a higher risk of breast cancer-specific death or recurrence (HR = 5.64, P = 0.008). In Multivariate model, just the nodal involvement significantly changed the hazard for OS (HR = 23.91, P = 0.001). As the nodal involvement was the only significant risk factor at the 0.2 level of significance, we can consider the hazard ratio of lymph node positivity in DFS univariate models as adjusted hazard.
CONCLUSION
The only factor with significant effect on OS, DFS and RI was nodal involvement in the pathology report.
背景
乳腺癌是女性癌症死亡的第二大原因。三阴性乳腺癌（TNBC）是一种具有独特行为的亚组。在转移的器官受累方面存在争议。在这项研究中，我们计划定义患者的预后因素、生存和复发发生率。
材料和方法
在 2005 年 3 月至 2015 年 3 月期间，583 名因乳房肿块就诊于伊朗德黑兰 Shariati 医院血液科和肿瘤科的患者中，有 54 名患者进入生存分析，我们对其进行了两年的随访，直到 2017 年 3 月。估计总生存率（OS）、无病生存率（DFS）和累积复发率（RI）。采用单变量和多变量 Cox 比例风险回归分析评估 OS 和 DFS 预测的危险因素。
结果
患者的中位随访时间为 5.00 年。患者的 5 年 OS、DFS 和 RI 分别为 86.13%（95%CI（71.42-93.59）、63.09%（95%CI（47.04-75.49）和 32.15%（95%CI（19.52-47.43）。在所研究的因素中，仅患者有无淋巴结受累的 OS、DFS 和 RI 差异有统计学意义（P=0.004、P=0.003 和 P=0.02）。另一方面，根据单变量建模，有淋巴结受累的患者发生乳腺癌特异性死亡的风险更高（HR：17.99，P=0.004）。此外，有淋巴结受累的患者发生乳腺癌特异性死亡或复发的风险更高（HR=5.64，P=0.008）。在多变量模型中，只有淋巴结受累显著改变了 OS 的危险（HR=23.91，P=0.001）。由于淋巴结受累是具有统计学意义的唯一风险因素，我们可以认为在 DFS 单变量模型中，淋巴结阳性的风险比是调整后的危险。
结论
在病理报告中，唯一对 OS、DFS 和 RI 有显著影响的因素是淋巴结受累。
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