Yazdani Akram, Haghighat Shahpar
Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran.
Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.
Breast Cancer (Auckl). 2022 Jun 29;16:11782234221108058. doi: 10.1177/11782234221108058. eCollection 2022.
The analysis of disease-free survival and related factors leads to a better understanding of the patient's condition and recurrence-related characteristics and provides a basis for more appropriate treatment guidance. In this study, we aimed to investigate the role of prognostic factors on disease-free survival in breast cancer with a quantile regression model.
This retrospective study was conducted by reviewing data obtained from 2056 breast cancer patients. Age at diagnosis and education status, tumor size, lymph node ratio, tumor grade, estrogen receptor and progesterone receptor, type of surgery, use of radiotherapy, chemotherapy, and hormone therapy were the prognosis factors considered in this study. A quantile regression model was used to investigate prognostic factors of disease-free survival in breast cancer.
Disease recurrence was verified in 251 (13.9%) women, and 39 (0.02%) women died before experience recurrence. The 10th percentile of disease-free survival for patients with the hormone therapy was 23.85 months greater than patients who did not receive this treatment ( value < .001). In the examination of the tumor size, the 10th and 20th percentiles of disease-free survival for patients with tumor size > 5 cm were 31.06 and 27 months less than patients with the tumor size < 2 cm, respectively ( value = .006 and .021, respectively). Compared with grade 1 tumors, the 10th and 20th percentiles of disease-free survival for patients with grade 3 tumors decreased 30.11 and 38.32 months, respectively ( value < .001 and .038, respectively). The 10th and 20th percentiles of disease-free survival decreased 28.16 and 45.32 months with a 1 unit increase in lymph node ratio, respectively ( value = .032 and .032, respectively).
Among the prognostic factors, tumor size, grade, and lymph node ratio showed a close relationship with disease-free survival in breast cancer. The findings indicated that developing public screening and educational programs through the health care system with more emphasis on low-educated women is needed among Iranian women.
对无病生存期及相关因素进行分析，有助于更好地了解患者病情及复发相关特征，并为更恰当的治疗指导提供依据。在本研究中，我们旨在采用分位数回归模型探讨预后因素在乳腺癌无病生存期中的作用。
本回顾性研究通过回顾2056例乳腺癌患者的数据进行。本研究纳入的预后因素包括诊断时年龄和教育程度、肿瘤大小、淋巴结比值、肿瘤分级、雌激素受体和孕激素受体、手术类型、放疗、化疗及激素治疗的使用情况。采用分位数回归模型研究乳腺癌无病生存期的预后因素。
251例（13.9%）女性出现疾病复发，39例（0.02%）女性在复发前死亡。接受激素治疗患者的无病生存期第10百分位数比未接受该治疗的患者长23.85个月（ 值<0.001）。在肿瘤大小检查中，肿瘤大小>5 cm患者的无病生存期第10和第20百分位数分别比肿瘤大小<2 cm的患者短31.06个月和27个月（ 值分别为0.006和0.021）。与1级肿瘤相比，3级肿瘤患者的无病生存期第10和第20百分位数分别减少30.11个月和38.32个月（ 值分别<0.001和0.038）。淋巴结比值每增加1个单位，无病生存期第10和第20百分位数分别减少28.16个月和45.32个月（ 值均为0.032）。
在预后因素中，肿瘤大小、分级和淋巴结比值与乳腺癌无病生存期密切相关。研究结果表明，伊朗女性需要通过医疗保健系统开展公共筛查和教育项目，且应更关注低教育程度女性。
