Collett K, Maehle B O, Skjaerven R, Hartveit F
Gade Institute, Department of Pathology, University of Bergen, Haukeland Hospital, Norway.
Oncology. 1994 Jul-Aug;51(4):323-8. doi: 10.1159/000227358.
This study of 786 node-negative breast cancer patients demonstrates that the prognostic effect of age at operation, tumor diameter and mean nuclear area (MNA) changed over time. Identifying patients at higher risk of dying after 5 years may be of clinical importance. These are patients who may have had a low metastatic tumor burden at the time of operation and in whom cytostatic adjuvant treatment could be of value. When estimating 10-year survival, a significant loss of strength was found for age. A near significant loss of effect was also found for MNA, while tumor diameter was the variable best maintaining prognostic power during the observation period. Due to the loss of strength for MNA and age when estimating 10-year survival, the observation period was divided into two periods. When estimating 5-year survival, MNA was the strongest variable, while tumor diameter and age gave additional significant information. When estimating the next 5 years, excluding patients who died before 5 years, only tumor diameter gave significant prognostic information (573 cases). This again stresses the importance of tumor diameter in assessing prognosis in node-negative patients.
这项针对786例淋巴结阴性乳腺癌患者的研究表明，手术年龄、肿瘤直径和平均核面积（MNA）的预后影响随时间而变化。识别出5年后死亡风险较高的患者可能具有临床重要性。这些患者在手术时可能转移瘤负荷较低，而细胞毒性辅助治疗对他们可能有价值。在估计10年生存率时，发现年龄的预后能力显著下降。MNA的影响也近乎显著下降，而在观察期内肿瘤直径是预后能力维持最佳的变量。由于在估计10年生存率时MNA和年龄的预后能力下降，观察期被分为两个阶段。在估计5年生存率时，MNA是最强的变量，而肿瘤直径和年龄也提供了额外的显著信息。在估计接下来的5年时，排除5年前死亡的患者，只有肿瘤直径提供了显著的预后信息（573例）。这再次强调了肿瘤直径在评估淋巴结阴性患者预后中的重要性。
