Long-term survival of T1 and T2 lymph node-negative breast cancer patients according to mitotic activity index: A population-based study
Long-term survival of T1 and T2 lymph node-negative breast cancer patients according to mitotic activity index: A population-based study
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DOI：
10.1002/ijc.21623
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发表时间：
2006-05-01
影响因子：
6.4
通讯作者：
Coebergh, JWW
中科院分区：
文献类型：
--
作者：
Louwman, WJ;van Beek, MWPM;Coebergh, JWW
淋巴结阴性乳腺癌患者的预后相对较好，但最终有三分之一会死于该病。因此，需要确定这些患者中高危人群的预后因素。我们回顾性测定了大量肿瘤小于 5 cm、仅接受局部治疗的淋巴结阴性乳腺癌患者 (n = 468) 的有丝分裂活动指数 (MAI)。对患者进行了长达 29 年的随访；计算单变量和多变量的粗生存率和相对生存率。相对生存率根据 MAI 存在显着差异 (p = 0.05)，差异发生在诊断后的前 5 年，此后保持不变。调整后，MAI 仍显着影响相对生存率（RER，1.9；95% CI，1.1-3.5）。肿瘤大小也会增加风险，但这并不具有统计学意义（RER，1.5；95% CI，0.8-2.7）。 T1 肿瘤且 MAI < 10 的患者在诊断后头 5 年的生存率与一般人群相似。总之，MAI 显着预测了 T1/T2N0 乳腺癌的长期生存率。无论 MAI 如何，辅助全身治疗似乎对 T1 期淋巴结阴性乳腺癌患者几乎没有什么益处。对于 T2 肿瘤且 MAI >= 10 的患者，全身治疗可能会降低死亡率。对 T1 期肿瘤且 MAI < 10 的淋巴结阴性乳腺癌患者进行密切监测的必要性似乎有限。 (c) 2005 年 Wiley-Liss, Inc.
Node-negative breast cancer patients have a relatively good prognosis, but eventually one-third will die of the disease. Thus, prognostic factors to identify the high-risk group among these patients are needed. We retrospectively determined the Mitotic Activity Index (MAI) for a large series of node-negative breast cancer patients (n = 468) with tumours smaller than 5 cm, who only received locoregional treatment. Patients were followed for up to 29 years; crude and relative survival were calculated, both univariate and multivariate. Relative survival differed significantly according to MAI (p = 0.05) the difference occurred in the first 5 years after diagnosis and remained constant thereafter. After adjustment, MAI still significantly affected relative survival (RER, 1.9; 95% CI, 1.1-3.5). Tumour size also increased the risk, but this was not statistically significant (RER, 1.5; 95% CI, 0.8-2.7). Survival of patients with a T1 tumour and MAI < 10 was similar to that for the general population in the first 5 years after diagnosis. In conclusion, MAI significantly predicted long-term survival for T1/T2N0 breast cancer. Adjuvant systemic therapy appears to have little benefit for node-negative breast cancer patients with a T1 tumour, regardless of the MAI. For those with a T2 tumour and a MAI >= 10 systemic therapy might have reduced mortality. The need for close surveillance of node-negafive breast cancer patients with a T1 tumour and MAI < 10 seems limited. (c) 2005 Wiley-Liss, Inc.