Estimate of tumor growth time for breast cancer local recurrences: rapid growth after wake-up?
Estimate of tumor growth time for breast cancer local recurrences: rapid growth after wake-up?
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DOI：
10.1023/a:1005887422022
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发表时间：
1998-09-01
影响因子：
3.8
通讯作者：
Bonadonna, G
中科院分区：
文献类型：
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作者：
Demicheli, R;Terenziani, M;Bonadonna, G
为了估计乳腺癌的亚临床肿瘤生长时间（TGT），对31例乳腺癌切除术后首次局部复发的患者进行了评价。测量复发直径，并获得与“先前体检未检测->复发直径Dr”序列一致的最小生长速率（mGR）。还计算了手术后不间断指数生长的生长率（GRu），mGR显著高于GRu（p < 0.0001），且与无复发生存期（RFS）无关。因此，局部复发生长曲线的起点必须设定在乳房切除术后不同的延迟时间。从mGR和GRu获得的延迟下限（mD）的估计值与RFS显示出强线性相关性（R = 0.984; p < 0.0001）。从回归方程，TGT局部复发可以估计在30 +/- 8 wk或less. These研究结果支持的概念，乳腺癌的手术治疗和局部复发的临床证据之间的滞后时间可以解释为一段时间的肿瘤休眠期，然后肿瘤生长阶段。TGT估计值比以前认为的要短得多，可能会大大改变目前乳腺癌史的情况。
To obtain an estimate of the subclinical tumor growth time (TGT) for breast cancer, a series of 31 patients with local recurrence as first event after mastectomy was evaluated. The recurrence diameter was measured, and the minimum growth rate (mGR) consistent with the sequence 'no detection at the preceding physical examination --> recurrence of diameter Dr' was obtained. The growth rate for uninterrupted exponential growth from surgery (GRu) was also calculated, mGR was significantly higher than GRu (p < 0.0001), and unrelated to the recurrence-free survival (RFS). Therefore, starting points of local recurrence growth curves had to be set at times variously delayed after mastectomy. The estimate of the delay lower limit (mD), which was obtained from mGR and GRu, showed a strong linear correlation with RFS (R = 0.984; p < 0.0001). From the regression equation, TGT for local recurrences could be estimated at 30 +/- 8 weeks or less. These findings support the concept that the lag time between surgical treatment of breast cancer and clinical evidence of local recurrence may be explained by a period of tumor dormancy followed by a tumor growing phase. The TGT estimate is remarkably shorter than previously believed and could considerably change the current picture of breast cancer history.