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三阴性乳腺癌的预后因素:回顾性队列研究。

Prognostic factors in triple-negative breast cancer: a retrospective cohort.

机构信息

Universidade Estadual do Piauí, Centro de Ciências da Saúde, Coordenação de Medicina - Teresina (PI), Brazil.

Hospital São Marcos, Cirurgia Plástica - Teresina (PI), Brazil.

出版信息

Rev Assoc Med Bras (1992). 2021 Jul;67(7):950-957. doi: 10.1590/1806-9282.20210249.

Abstract

OBJECTIVE

Triple-negative breast cancer (TNBC) is characterized by lack of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) expression and accounts for 15-20% of all breast cancers. This study aims to analyze prognostic factors related to a reduction in overall survival (OS), disease-free survival (DFS), and risk of mortality and recurrence in TNBC.

METHODS

This is a retrospective observational cohort study. Medical records of 532 patients with breast cancer diagnosed from 2007 to 2020 were analyzed. Of these patients, 93 (17%) were women with TNBC. Ten medical records were excluded, and the final sample was composed of 83 women with TNBC. OS and DFS were estimated by the Kaplan-Meier model. Univariate analysis (log-rank test) and multivariate analysis (Cox regression) were used to examine prognostic factors related to a statistically significant reduction (p<0.05) in OS and DFS and increased risk of mortality and tumor recurrence.

RESULTS

Smoking, advanced clinical stage, larger tumor size, angiolymphatic invasion, positive sentinel lymph node, axillary node involvement, higher cancer burden, surgical treatment with mastectomy, and recurrence were related to a significant decrease in OS and/or DFS and increased risk of mortality and/or recurrence in TNBC. The 10-year OS and DFS was around 61 and 65%, respectively.

CONCLUSIONS

Advanced clinical stage, positive sentinel lymph node, axillary node involvement, surgical treatment with mastectomy, and higher residual cancer burden were related to a significant reduction in OS and DFS and increased risk of mortality and recurrence in TNBC.

摘要

目的

三阴性乳腺癌(TNBC)的特点是缺乏雌激素受体、孕激素受体和人表皮生长因子受体 2(HER2)的表达,占所有乳腺癌的 15-20%。本研究旨在分析与总生存期(OS)、无病生存期(DFS)以及 TNBC 患者死亡和复发风险降低相关的预后因素。

方法

这是一项回顾性观察性队列研究。分析了 2007 年至 2020 年诊断的 532 例乳腺癌患者的病历。其中,93 例(17%)为 TNBC 女性患者。排除了 10 份病历,最终样本由 83 例 TNBC 女性患者组成。通过 Kaplan-Meier 模型估计 OS 和 DFS。使用单因素分析(对数秩检验)和多因素分析(Cox 回归)来检查与 OS 和 DFS 显著降低(p<0.05)以及死亡率和肿瘤复发风险增加相关的预后因素。

结果

吸烟、临床晚期、肿瘤较大、血管淋巴管侵犯、前哨淋巴结阳性、腋窝淋巴结受累、癌症负担较高、接受乳房切除术的手术治疗以及复发与 OS 和/或 DFS 显著降低以及 TNBC 患者的死亡率和/或复发风险增加相关。10 年 OS 和 DFS 分别约为 61%和 65%。

结论

临床晚期、前哨淋巴结阳性、腋窝淋巴结受累、乳房切除术治疗以及残留癌症负担较高与 TNBC 的 OS 和 DFS 显著降低以及死亡率和复发风险增加相关。

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