Hazard of Recurrence among Women after Primary Breast Cancer Treatment-A 10-Year Follow-up Using Data from SEER-Medicare
Hazard of Recurrence among Women after Primary Breast Cancer Treatment-A 10-Year Follow-up Using Data from SEER-Medicare
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DOI：
10.1158/1055-9965.epi-11-1089
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发表时间：
2012-05-01
影响因子：
3.8
通讯作者：
Giordano, Sharon H.
中科院分区：
文献类型：
--
作者：
Cheng, Lee;Swartz, Michael D.;Giordano, Sharon H.
背景：很少有研究使用SEER-Medicare数据来描述美国女性乳腺癌初次治疗后的复发情况。方法：我们使用SEER-Medicare数据估计1991年至1997年间乳腺癌女性复发的年危险率（HR），随访10年。采用Kaplan-Meier法推导HR。采用多变量Cox比例风险模型估计复发相关预后因素的相对危险度。结果：20,027名女性中，36.8%的患者在10年内复发，其中大部分（81.9%）发生在诊断后5年内。在前5年内，III期女性的HR峰值和幅度均高于I期和II期女性（P均< 0.01）。肿瘤激素受体状态阴性的妇女在前5年内发生复发的峰值危险较高（P < 0.01），但随访5年后的危险显著低于激素受体状态阳性或未知的妇女（P < 0.05）。经初次治疗后，低分化组织学级别肿瘤的妇女前5年的HR高于其他级别的妇女（P均< 0.01）。乳腺癌复发风险增加与晚期、中、差不同分级、激素受体状态阴性相关（均P < 0.01）。结论：复发的hr在10年内是动态的，并明显取决于诊断时的预后因素。影响：我们的研究表明，女性的最佳随访可能有所不同。癌症流行病学生物标志物；21 (5);800 - 9。AACR 2012 (C)。
Background: Few studies have used SEER-Medicare data to describe recurrence of breast cancer after primary treatment for U.S. women.Methods: We used SEER-Medicare data to estimate the annual hazard rate (HR) of recurrence for women with breast cancer between 1991 and 1997 with 10 years of follow-up. The Kaplan-Meier method was used to derive the HR. Multivariate Cox proportional hazards model was used to estimate the relative hazard of the recurrence-associated prognostic factors.Results: Of 20,027 women, 36.8% had recurrence within 10 years, with most of these recurrences (81.9%) occurring within 5 years after diagnosis. Women with stage III cancer showed the highest HR peak and largest magnitude than women with stage I or II disease (both P < 0.01) within the first 5 years. Women with negative tumor hormone receptor status had a higher peak hazard of developing recurrence within the first 5 years (P < 0.01), but the hazards were remarkably lower beyond 5 years of follow-up than in women with positive or unknown hormone receptor status (P > 0.05). Women with poorly differentiated histologic grade tumors showed higher HR in the first 5 years than women with other grades after primary treatment (both P < 0.01). The increased risk of recurrence of breast cancer was associated with advanced stage, moderate and poorly differently grades, and negative hormone receptor status (all P < 0.01).Conclusion: The HRs of the recurrence are dynamic over 10 years and are markedly determined by prognostic factors at diagnosis.Impact: Our study suggests that the optimal follow-up may differ among women. Cancer Epidemiol Biomarkers Prey; 21(5); 800-9. 2012 (C)AACR.