第二原发癌对首发乳腺癌患者死亡率的影响。

The contribution of second primary cancers to the mortality of patients with a first primary breast cancer.

机构信息

EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-091, Porto, Portugal.

Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.

出版信息

Breast Cancer Res Treat. 2024 Sep;207(2):323-330. doi: 10.1007/s10549-024-07361-3. Epub 2024 Jun 13.

DOI:10.1007/s10549-024-07361-3

PMID:38869665

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11297125/

Abstract

PURPOSE

Second primary cancers (SPCs) are estimated to affect nearly 5% of patients with breast cancer within 10 years of their diagnosis. This study aimed to estimate the contribution of SPCs to the mortality of patients with a breast first primary cancer (FPC).

METHODS

A population-based cohort of 17,210 patients with a breast FPC diagnosed between 2000 and 2010 was followed for SPCs (31/12/2015) and vital status (30/06/2021). Patients diagnosed with an SPC (265 synchronous and 897 metachronous, ≤ 1 and > 1 year after the FPC, respectively) were matched (1:3, by five-year age group and year of breast FPC diagnosis) to those without an SPC and alive when the corresponding SPC was diagnosed.

RESULTS

Significantly higher hazards of death were found among patients with an SPC [hazard ratio of 1.56, 95% confidence interval (CI) 1.29-1.89 for synchronous SPCs; and 2.85, 95%CI 2.56-3.17 for metachronous SPCs] compared to patients with a breast FPC only. Estimates were higher for synchronous lung, stomach, non-Hodgkin lymphoma and breast SPCs, and metachronous liver, stomach, ovary, lung, rectum, corpus uteri, colon, breast, and non-Hodgkin lymphoma SPCs. The 15-year cumulative mortality was 59.5% for synchronous SPCs and 68.7% for metachronous SPCs, which was higher than in patients with a breast FPC only (43.6% and 44.8%, respectively).

CONCLUSIONS

In Northern Portugal, patients with an SPC following a breast FPC have a higher mortality compared with patients with a breast FPC only.

摘要

目的

据估计，在诊断出乳腺癌后的 10 年内，约有 5%的乳腺癌患者会患上第二原发癌（SPC）。本研究旨在评估 SPC 对乳腺癌首发癌（FPC）患者死亡的影响。

方法

本研究为基于人群的队列研究，纳入了 17210 例 2000 年至 2010 年间诊断为乳腺癌 FPC 的患者，随访 SPC（2021 年 12 月 31 日）和生存状态（2021 年 6 月 30 日）。诊断为 SPC（265 例同步，897 例异时，分别在 FPC 后≤1 年和>1 年）的患者与未发生 SPC 且在相应 SPC 诊断时仍存活的患者按年龄（每 5 岁为一组）和 FPC 诊断年份（每 1 年为一组）1:3 进行匹配。

结果

与仅有乳腺癌 FPC 的患者相比，患有 SPC 的患者死亡风险显著更高（同步 SPC 的风险比为 1.56，95%CI 为 1.29-1.89；异时 SPC 的风险比为 2.85，95%CI 为 2.56-3.17）。与仅有乳腺癌 FPC 的患者相比，患有同步肺癌、胃癌、非霍奇金淋巴瘤和乳腺癌 SPC 的患者，以及患有异时性肝、胃、卵巢、肺、直肠、子宫、结肠、乳腺癌和非霍奇金淋巴瘤 SPC 的患者的风险比更高。同步 SPC 的 15 年累积死亡率为 59.5%，异时 SPC 的 15 年累积死亡率为 68.7%，均高于仅有乳腺癌 FPC 的患者（分别为 43.6%和 44.8%）。