Department of Thyroid and Breast Surgery, Yangzhou University Affiliated Northern Jiangsu People's Hospital, Yangzhou, China.
J Cancer Res Ther. 2023 Apr;19(Supplement):S0. doi: 10.4103/jcrt.jcrt_90_21.
INTRODUCTION: Age at diagnosis has shown significant effect on the prognosis in breast cancer patients. However, whether age is an independent risk factor remains controversial. Furthermore, population-based estimates of age on the prognosis impact in triple-negative breast cancer are still lacking. The aim of this study was to analyze the influence of age and other factors on the prognosis and survival of triple-negative breast cancer patients. MATERIALS AND METHODS: We used the surveillance, epidemiology, and end results program data from 2011 to 2014. A retrospective cohort study was conducted to investigate prognosis factors in triple-negative breast cancer. Patients were divided into two groups according to age at diagnosis: 75 + years (the elderly patients) and < 75 years (reference group). The clinicopathologic characteristics of different age groups were compared using Chi-square tests. Overall survival (OS) and breast cancer-specific survival were analyzed using the Kaplan-Meier method. Prognostic factors were compared using the Cox proportional hazards model. We also analyzed the difference of distant metastasis at initial diagnosis on every group. RESULTS: A total of 21,429 triple-negative breast cancer patients were included in our study. The mean breast cancer-specific survival time of triple-negative breast cancer was 70.5 months for the reference group and 62.4 months for the elderly group. Survival analysis showed that the breast cancer-specific survival rate was 78.9% for the reference group and 67.4% for the elderly group. The mean OS time was 69.0 months for the reference group and 52.3 months for the elderly group. The 5-year OS of triple-negative breast cancer patients was 76.4% for the reference group and 51.3% for the elderly group. The prognosis of elderly patients is much poor than reference group. Univariate Cox regression analysis showed that age, race, marital status, histological grade, stage, T, N, M, surgery, radiotherapy, and chemotherapy were risk factors for triple-negative breast cancer (TNBC) (P < 0.05). Multivariate Cox regression analysis showed that age, race, marital status, histological grade, stage, T, N, M, surgery, radiotherapy, and chemotherapy were independent risk factors for TNBC (P < 0.05). CONCLUSIONS: Age is an independent risk factor for the prognosis of TNBC patients. Elderly triple-negative breast cancer patients displayed obvious lower 5-year survival rate compared to reference group, even though they have better grade stage, minor tumor, less lymph node metastasis. The lower rate of marital status, radiotherapy, chemotherapy, surgery, and higher rate of metastasis at diagnosis must contribute to their poor outcome.
简介:诊断时的年龄对乳腺癌患者的预后有显著影响。然而,年龄是否是一个独立的危险因素仍存在争议。此外,三阴性乳腺癌患者预后影响的基于人群的年龄估计仍然缺乏。本研究旨在分析年龄和其他因素对三阴性乳腺癌患者预后和生存的影响。
材料和方法:我们使用了 2011 年至 2014 年的监测、流行病学和最终结果计划数据。进行了回顾性队列研究,以调查三阴性乳腺癌的预后因素。根据诊断时的年龄将患者分为两组:75 岁及以上(老年患者)和<75 岁(参考组)。使用卡方检验比较不同年龄组的临床病理特征。使用 Kaplan-Meier 法分析总生存期(OS)和乳腺癌特异性生存期。使用 Cox 比例风险模型比较预后因素。我们还分析了每组初始诊断时远处转移的差异。
结果:共有 21429 例三阴性乳腺癌患者纳入本研究。参考组三阴性乳腺癌的平均乳腺癌特异性生存时间为 70.5 个月,老年组为 62.4 个月。生存分析显示,参考组的乳腺癌特异性生存率为 78.9%,老年组为 67.4%。参考组的平均 OS 时间为 69.0 个月,老年组为 52.3 个月。三阴性乳腺癌患者的 5 年 OS 为参考组的 76.4%,老年组的 51.3%。老年患者的预后明显差于参考组。单因素 Cox 回归分析显示,年龄、种族、婚姻状况、组织学分级、分期、T、N、M、手术、放疗和化疗是三阴性乳腺癌(TNBC)的危险因素(P<0.05)。多因素 Cox 回归分析显示,年龄、种族、婚姻状况、组织学分级、分期、T、N、M、手术、放疗和化疗是 TNBC 的独立危险因素(P<0.05)。
结论:年龄是三阴性乳腺癌患者预后的独立危险因素。与参考组相比,老年三阴性乳腺癌患者的 5 年生存率明显较低,尽管他们的分级分期较好,肿瘤较小,淋巴结转移较少。较低的婚姻状况、放疗、化疗、手术率和较高的初诊转移率必然导致他们的不良结局。
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