Hietanen P, Miettinen M, Mäkinen J
Eur J Cancer Clin Oncol. 1986 Aug;22(8):913-9. doi: 10.1016/0277-5379(86)90056-8.
The aim of the present study was to evaluate the significance of primary stage, histopathological grade, disease-free survival and site of first relapse on survival after first recurrence. The study included 1621 female breast cancer patients admitted between 1970 and 1975. The patient material was analysed by unifactorial life table methods and the multifactorial Cox regression analysis. The primary stage and histopathological grade maintained a significant prognostic value also after relapse. Survival after first recurrence was dependent on the disease-free interval and site of first relapse, too. If the disease-free survival was over 5 years, 44% of the patients were still alive after 7 years from recurrence. Of the patients with a disease-free survival shorter than 2 years, only 10% were alive after 7 years from recurrence. Survival was significantly better after locoregional relapse than after distant relapse, but the difference levelled off within 7 years. The prognosis of axillary relapse was best and that of liver and brain metastases poorest. Regression analysis confirmed the importance of primary stage, site of recurrence and histopathological grade as prognostic variables for survival after first recurrence.
本研究的目的是评估首次复发时的原发阶段、组织病理学分级、无病生存期和首次复发部位对生存的意义。该研究纳入了1970年至1975年间收治的1621例女性乳腺癌患者。采用单因素生命表法和多因素Cox回归分析对患者资料进行分析。复发后,原发阶段和组织病理学分级仍具有显著的预后价值。首次复发后的生存也取决于无病间期和首次复发部位。如果无病生存期超过5年,44%的患者在复发后7年仍存活。无病生存期短于2年的患者中,复发后7年仅有10%存活。局部区域复发后的生存明显优于远处复发,但7年内差异趋于平稳。腋窝复发的预后最好,肝转移和脑转移的预后最差。回归分析证实了原发阶段、复发部位和组织病理学分级作为首次复发后生存预后变量的重要性。