Survival Outcomes of Breast-Conserving Therapy versus Mastectomy in Early-Stage Breast Cancer, Including Centrally Located Breast Cancer: A SEER-Based Study.
Survival Outcomes of Breast-Conserving Therapy versus Mastectomy in Early-Stage Breast Cancer, Including Centrally Located Breast Cancer: A SEER-Based Study.
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早期乳腺癌（包括中央型乳腺癌）保乳治疗与乳房切除术的生存结果：一项基于 SEER 的研究
DOI：
10.1155/2022/5325556
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发表时间：
2022
期刊：
影响因子：
--
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中科院分区：
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--
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本研究旨在分析乳腺癌（BC）患者的生存结局，特别是接受保乳治疗（BCT）或乳房切除术的中心型乳腺癌（CLBC）患者。 对接受BCT或乳房切除术的T1-T2浸润性导管或小叶乳腺癌患者的监测、流行病学和最终结果（SEER）数据进行了回顾。我们使用X-tile软件将连续变量转换为分类变量。采用卡方检验比较基线信息。采用多因素Logistic回归模型分析预测变量与治疗选择的关系。通过Kaplan-Meier曲线和累积发生率函数曲线观察生存结局，并使用多变量分析进行比较，包括考克斯比例风险模型和竞争风险模型。进行倾向评分匹配以减轻基线差异对生存结局的影响。 共有180，495例患者入组本研究。从2000年到2015年，乳房保留率在60%左右波动。在BC和CLBC队列中，浸润性导管癌（IDC）、较低的组织学分级、较小的肿瘤大小、较少的淋巴结转移、阳性ER和PR状态以及化疗使用等临床特征与BCT独立相关。在所有经典的考克斯模型和竞争风险模型中，BCT是BC的独立有利预后因素，包括大多数亚组的CLBC患者。此外，尽管与位于其他区域的肿瘤相比，CLBC的保乳率较低，但它并不影响BCT患者的预后。 对于大多数早期BC，包括CLBC患者，BCT是可选的和优选的。
This study aims to analyze the survival outcomes of breast cancer (BC) patients, especially centrally located breast cancer (CLBC) patients undergoing breast-conserving therapy (BCT) or mastectomy. Surveillance, epidemiology, and end results (SEER) data of patients with T1-T2 invasive ductal or lobular breast cancer receiving BCT or mastectomy were reviewed. We used X-tile software to convert continuous variables to categorical variables. Chi-square tests were utilized to compare baseline information. The multivariate logistic regression model was performed to evaluate the relationship between predictive variables and treatment choice. Survival outcomes were visualized by Kaplan–Meier curves and cumulative incidence function curves and compared using multivariate analyses, including the Cox proportional hazards model and competing risks model. Propensity score matching was performed to alleviate the effects of baseline differences on survival outcomes. A total of 180,495 patients were enrolled in this study. The breast preservation rates fluctuated around 60% from 2000 to 2015. Clinical features including invasive ductal carcinoma (IDC), lower histologic grade, smaller tumor size, fewer lymph node metastases, positive ER and PR status, and chemotherapy use were independently correlated with BCT in both BC and CLBC cohorts. In all the classic Cox models and competing risks models, BCT was an independent favorable prognostic factor for BC, including CLBC patients in most subgroups. In addition, despite the low breast-conserving rate compared with tumors located in the other areas, CLBC did not impair the prognosis of BCT patients. BCT is optional and preferable for most early-stage BC, including CLBC patients.
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影响因子：
3.7
作者：
Suami, Hiroo;Pan, Wei-Ren;Taylor, G. Ian
通讯作者：
Taylor, G. Ian
影响因子：
9
作者：
Fitzal, Florian;Mittlboeck, Martina;Gnant, Michael
通讯作者：
Gnant, Michael
影响因子：
3.7
作者：
Hartmann-Johnsen OJ;Kåresen R;Schlichting E;Nygård JF
通讯作者：
Nygård JF
影响因子：
3.1
作者：
Blichert-Toft, Mogens;Nielsen, Maja;Mouridsen, Henning T.
通讯作者：
Mouridsen, Henning T.
影响因子：
51.1
作者：
Litiere, Saskia;Werutsky, Gustavo;Bartelink, Harry
通讯作者：
Bartelink, Harry