Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
PLoS One. 2022 Mar 16;17(3):e0265533. doi: 10.1371/journal.pone.0265533. eCollection 2022.
The aim of this study was to evaluate the chronological changes over 14 years in the survival of Korean patients with breast cancer. We also sought to investigate the factors that may have influenced the changes in survival rate.
We retrospectively analyzed 17,776 breast cancer patients who were treated at Asan Medical Center between January 2000 and December 2013. Patient information was collected from the Asan database, including age at diagnosis, clinical manifestation, pathology report, types of treatment and modality, types of recurrence, and follow-up period. We classified the patients into two cohorts according to the year of their surgery (P1: 2000-2007 and P2: 2008-2013) and compared survival and recurrence between both cohorts.
We observed that patients treated more recently had better survival outcomes. The 5-year breast cancer-specific survival increased from 94.0% in P1 to 96.6% in P2 (p<0.001), and the 5-year disease-free survival increased from 87.9% in P1 to 91.2% in P2 (p<0.001). When analyzed by type of recurrence, distant metastasis-free survival increased to a significant degree. In subgroup analysis by the subtypes of breast cancer, the survival rates improved in all of the subtypes except triple negative breast cancer, and the improvement was more prominent in subtypes with overexpressed human epidermal growth factor receptor 2.
This study showed improvement in breast cancer survival over the succeeding years, which is consistent with the advancement in systemic therapy.
本研究旨在评估韩国乳腺癌患者 14 年来的生存时间变化,并探讨可能影响生存率变化的因素。
我们回顾性分析了 2000 年 1 月至 2013 年 12 月期间在 Asan 医疗中心接受治疗的 17776 例乳腺癌患者的资料。患者信息从 Asan 数据库中收集,包括诊断时的年龄、临床表现、病理报告、治疗和治疗方式类型、复发类型和随访期。我们根据手术年份将患者分为两组(P1:2000-2007 年和 P2:2008-2013 年),并比较了两组之间的生存和复发情况。
我们观察到最近接受治疗的患者生存结局更好。5 年乳腺癌特异性生存率从 P1 组的 94.0%提高到 P2 组的 96.6%(p<0.001),5 年无病生存率从 P1 组的 87.9%提高到 P2 组的 91.2%(p<0.001)。按复发类型分析时,远处转移无复发生存率显著提高。乳腺癌亚组分析中,除三阴性乳腺癌外,所有亚型的生存率均有所提高,且人表皮生长因子受体 2 过表达亚型的改善更为显著。
本研究显示随着系统治疗的进步,乳腺癌的生存时间逐年改善。