Prognostic factors for survival after first recurrence in breast cancer: a retrospective analysis of 252 recurrent cases at a single institution
Prognostic factors for survival after first recurrence in breast cancer: a retrospective analysis of 252 recurrent cases at a single institution
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DOI：
10.1007/s12282-012-0358-x
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发表时间：
2014-01-01
期刊：
影响因子：
4
通讯作者：
Inamoto, Takashi
中科院分区：
文献类型：
--
作者：
Tsuji, Wakako;Teramukai, Satoshi;Inamoto, Takashi
以前的研究表明，雌激素受体(ER)阳性的乳腺癌患者在总体生存率和无病间隔(DFI)方面都有更好的结果。然而，我们的ER阳性患者中有25.2%复发。这项研究旨在确定I-III期乳腺癌手术治疗患者首次复发后的潜在预后因素。我们回顾分析了252名在日本京都大学医院接受手术并接受随访的复发乳腺癌女性患者。分析年龄、临床分期、病理分期、腋窝淋巴结转移、确诊时ER状态、孕激素受体状态、人表皮生长因子受体2状态、手术方式、辅助化疗、辅助内分泌治疗、复发后曲妥珠单抗的使用、复发部位、DFI和复发时间对首次复发后生存的可能影响。诊断时ER阳性和PR阳性是影响首次复发患者首次复发后生存的显著因素，p<；0.001和p=0.021。多因素分析显示，两个以上的复发部位(p<；0.001)与首次复发后较短的生存时间有关。从1980-1994到1995-2008年间，复发乳腺癌患者的生存率稳步提高，在ER阴性的亚组中尤为显著。确诊时ER状态阳性是首次复发后有利生存的有力预测因子。近几十年来，乳腺癌首次复发后的生存时间稳步增加。乳腺癌治疗方法和态度的进步有助于提高首次复发后的存活率。
Previous studies have shown that primary breast cancer patients with estrogen receptor (ER)-positive status have better outcomes in terms of both overall survival and disease-free intervals (DFI). However, 25.2 % of our ER-positive patients experienced recurrence. This study aimed to define factors potentially predicting survival after first recurrence in surgically treated patients with stage I-III breast cancer.We retrospectively analyzed 252 females with recurrent breast cancer who had undergone surgery and been followed at Kyoto University Hospital in Japan. Age, clinical stage, pathological stage, axillary lymph node involvement, ER status at the time of diagnosis, progesterone receptor status, human epidermal growth factor receptor 2 status, operative method, adjuvant chemotherapy, adjuvant endocrine therapy, use of trastuzumab after recurrence, site of recurrence, DFI, and time of recurrence were examined for possible influences on survival after the first recurrence.Positive ER status and positive PR status at the time of diagnosis were significantly favorable factors of survival after first recurrence for patients with recurrence, p < 0.001 and p = 0.021, respectively. More than two sites of recurrence (p < 0.001) were associated with shorter survival time after the first recurrence on multivariate analysis. Survival of patients with recurrent breast cancer steadily improved from 1980-1994 to 1995-2008, significantly in ER-negative subgroups.Positive ER status at the time of diagnosis is a powerful predictor for favorable survival after first recurrence. Survival time after first recurrence of breast cancer has steadily increased in recent decades. Advances in treatments and attitudes about breast cancer have contributed to this improvement in survival after first recurrence.