Flores-Balcázar Christian H, Flores-Luna Ma L, Villarreal-Garza Cynthia M, Bargalló-Rocha Juan E
Department of Radiation-Oncology, National Cancer Institute, 22 San Fernando Ave, Section XVI, Tlalpan, Mexico City 14080, Mexico.
Department of Epidemiology, National Institute of Public Health, 50 Fray Pedro de Gante, Section XVI, Tlalpan, Mexico City 14080, Mexico.
Rep Pract Oncol Radiother. 2020 Mar-Apr;25(2):271-275. doi: 10.1016/j.rpor.2020.02.002. Epub 2020 Feb 21.
The goal of this study was to determine whether a delay in starting treatment via surgery or neoadjuvant chemotherapy is related to a decrease in cancer-specific survival (CSS) in women with operable breast cancer (BrCr).
Limited medical infrastructure and a lack of cancer prevention awareness in low- and middle-income countries have caused high BrCr incidence and mortality rates.
We analyzed a retrospective cohort of 720 women treated at a single center from 2005 to 2012. CSS estimates were obtained by the Kaplan-Meier method. A Cox model of proportional risks was performed to obtain the risk of dying from BrCr. We also obtained the risk according to the category of treatment initiation.
Women with locally advanced stages and without hormone receptor expression were more likely to initiate treatment after 45 days. Patients in Stage IIIA had a 78.1% survival if treatment was initiated before 45 days (95% CI, 0.70-0.84) and 63.6% survival if treatment was started after 45 days (95% CI, 0.44-0.78; p < 0.001). Patients in Stage IIIB had a 62.9% survival if treatment was initiated before 45 days (95% CI, 0.53-0.72) and 57.4% survival if treatment started after 45 days (95% CI, 0.31-0.89; p < 0.001). Prognostic factors in which lower survival was recognized were Stage IIIA, Stage IIIB, treatment initiation after 45 days, and triple-negative tumors.
The initiation of treatment within the first 45 days of diagnosis of BrCr in women portends better survival compared with those who began treatment longer than 45 days from diagnosis.
本研究的目的是确定手术或新辅助化疗开始时间的延迟是否与可手术乳腺癌（BrCr）女性患者的癌症特异性生存率（CSS）降低有关。
低收入和中等收入国家医疗基础设施有限以及癌症预防意识缺乏导致BrCr发病率和死亡率居高不下。
我们分析了2005年至2012年在单一中心接受治疗的720名女性的回顾性队列。通过Kaplan-Meier方法获得CSS估计值。进行比例风险Cox模型以获得死于BrCr的风险。我们还根据治疗开始类别获得了风险。
局部晚期且无激素受体表达的女性更有可能在45天后开始治疗。IIIA期患者如果在45天前开始治疗，生存率为78.1%（95%CI，0.70 - 0.84），如果在45天后开始治疗，生存率为63.6%（95%CI，0.44 - 0.78；p < 0.001）。IIIB期患者如果在45天前开始治疗，生存率为62.9%（95%CI，0.53 - 0.72），如果在45天后开始治疗，生存率为57.4%（95%CI，0.31 - 0.89；p < 0.001）。生存率较低的预后因素为IIIA期、IIIB期、45天后开始治疗以及三阴性肿瘤。
与诊断后超过45天开始治疗的女性相比，BrCr女性患者在诊断后的前45天内开始治疗预示着更好的生存率。
