1858例非转移性乳腺癌年轻女性患者的无病生存和总生存情况，以及根据临床亚型参与治疗后康复计划的情况。
Conditional Disease-Free and Overall Survival of 1,858 Young Women with Non-Metastatic Breast Cancer and with Participation in a Post-Therapeutic Rehab Programme according to Clinical Subtypes.
作者信息
Pruessmann Jonathan, Pursche Telja, Hammersen Friederike, Katalinic Alexander, Fischer Dorothea, Waldmann Annika
机构信息
Institute for Social Medicine and Epidemiology, Lübeck University, Lübeck, Germany.
Department of Gynaecology and Obstetrics, University Hospital Schleswig-Holstein, Lübeck, Germany.
出版信息
Breast Care (Basel). 2021 Apr;16(2):163-172. doi: 10.1159/000507315. Epub 2020 May 13.
BACKGROUND
Breast cancer in young women is associated with unfavourable tumour biology and is the main cause of death in this group. Conditional survival analysis estimates survival rates under the pre-condition of already having survived a certain time.
OBJECTIVES
To describe conditional disease-free and overall survival of female breast cancer patients according to clinical subtypes and age.
METHODS
This study analyses information from 1,858 breast cancer patients aged between 21 and 54 years, who were taking part in a post-therapeutic rehab programme (time between diagnosis and rehab start: maximum 24, median 11 months). Mean follow-up time was 3.6 years. We describe biological, clinical and pathological features in regard to different age groups (<40 and ≥40 years) and report conditional 5-year survival rates for overall and disease-free survival, and Cox proportional hazard models.
RESULTS
Very young and young patients differed in regard to hormone receptor negativity, tumour grade, lymphovascular invasion, and molecular subtypes. Young women bore triple-negative and HER2-like disease more frequently. Conditional 5-year overall survival did not differ substantially between women <40 and 40-54 years of age (95 vs. 96%). It was highest for women with cancer of the luminal A subtype (98%) and lowest for the triple-negative subtype (91%). Lymphangiosis was a significant predictor of death. Results for disease-free survival were comparable.
CONCLUSIONS
Conditional 5-year overall survival after non-metastatic breast cancer was as high as 95.5%, and disease-free survival was 85.2%. When controlling for time between diagnosis and rehab start, molecular subtypes influenced overall and disease-free survival prospects. When additionally controlling for clinical characteristics, this effect only remained stable for disease-free survival.
背景
年轻女性乳腺癌与不良肿瘤生物学特性相关，是该群体主要死因。条件生存分析估计在已存活一定时间的前提下的生存率。
目的
根据临床亚型和年龄描述女性乳腺癌患者的无病生存和总生存情况。
方法
本研究分析了1858例年龄在21至54岁之间参与治疗后康复计划的乳腺癌患者的信息（诊断与康复开始之间的时间：最长24个月，中位数11个月）。平均随访时间为3.6年。我们描述了不同年龄组（<40岁和≥40岁）的生物学、临床和病理特征，并报告了总生存和无病生存的条件5年生存率以及Cox比例风险模型。
结果
非常年轻和年轻患者在激素受体阴性、肿瘤分级、淋巴管侵犯和分子亚型方面存在差异。年轻女性更常患三阴性和HER2样疾病。<40岁和40 - 54岁女性的条件5年总生存率差异不大（95%对96%）。管腔A型癌症患者的生存率最高（98%），三阴性亚型患者的生存率最低（91%）。淋巴管炎是死亡的重要预测因素。无病生存结果类似。
结论
非转移性乳腺癌后的条件5年总生存率高达95.5%，无病生存率为85.2%。在控制诊断与康复开始之间的时间后，分子亚型影响总生存和无病生存前景。在进一步控制临床特征后，这种影响仅在无病生存方面保持稳定。
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