Prognostic factors predicting survival from first recurrence in patients with metastatic breast cancer: analysis of 439 patients
Prognostic factors predicting survival from first recurrence in patients with metastatic breast cancer: analysis of 439 patients
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DOI：
10.1023/a:1006285726561
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发表时间：
1999-07-01
影响因子：
3.8
通讯作者：
Garcia-Conde, J
中科院分区：
文献类型：
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作者：
Insa, A;Lluch, A;Garcia-Conde, J
我们对439例复发乳腺癌患者进行了回顾性分析，并在同一机构进行了随访，以确定首次复发时可能影响生存的预后因素。首次复发时的中位年龄为58岁，从最初诊断到复发的中位无病间隔(DFI)为33个月。13%的患者没有接受任何辅助治疗，87%的患者接受了不同组合的化疗、放射治疗和激素治疗作为辅助治疗。中位随访时间为44个月，中位生存期为24个月(SE 1.24)，5年总生存率为18%(SE 2.02)。在单因素分析中，确诊时的病理肿瘤大小(p<；0.0006)、确诊时的腋窝淋巴结状态(p<；0.00001)、雌激素受体(ER)阴性状态(p<；0.0001)、孕激素受体(Pgr)阴性状态(p<；0.0001)、辅助化疗(p<；0.001)、无病间隔(p<；0.00001)、复发位置(p<；0.0002)和转移灶数目(大于或等于3：P，小于或等于0.0003)与首次复发的较短生存期显著相关。在多因素分析中，只有复发部位、确诊时腋窝淋巴结状况、ER状态和DFI与首次复发后MSR降低独立相关。
We have analyzed retrospectively 439 women with recurrent breast cancer, followed at a single institution, in order to define potential prognostic factors for survival at the time of first recurrence. Median age at the time of first recurrence was 58 and the median disease free interval (DFI) from initial diagnoses to recurrence was 33 months. Thirteen percent of the patients did not receive any adjuvant therapy while 87% received different combinations of chemotherapy, radiotherapy and hormone therapy as adjuvant treatment. With a median follow-up of 44 months from the time of recurrence the median survival (MSR) was 24 months (SE 1.24) and five-year overall survival was 18% (SE 2.02). On the univariate analysis, pathological tumor size (pT) at diagnosis (p < 0.0006), axillary lymph node status at diagnosis (p < 0.00001), negative estrogen receptor (ER) status (p < 0.0001), negative progesterone receptor (PgR) status (p < 0.0001), adjuvant chemotherapy (p < 0.001), disease free interval (p < 0.00001), location of recurrence (p < 0.0002) and number of metastatic sites (greater than or equal to 3: p, less than or equal to 0.0003), were significantly associated with shorter survival from first relapse. On the multivariate analysis, only the site of recurrence, axillary lymph node status at diagnosis, ER status and DFI remained independently associated with decreased MSR after first relapse.