Factors affecting 5-and 10-year survival of women with breast cancer: An analysis based on a public general hospital in Barcelona
Factors affecting 5-and 10-year survival of women with breast cancer: An analysis based on a public general hospital in Barcelona
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DOI：
10.1016/j.canep.2012.07.003
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发表时间：
2012-12-01
影响因子：
2.6
通讯作者：
Castells, Xavier
中科院分区：
文献类型：
--
作者：
Macia, Francesc;Porta, Miquel;Castells, Xavier
背景：来自历史悠久的医院癌症登记处的数据被用来分析原发性乳腺癌女性的临床和组织因素与疾病特异性生存之间的关系。方法：通过德尔玛医院癌症登记处（西班牙巴塞罗那）确定了 1992 年至 2005 年诊断出的 2023 名罹患浸润性乳腺癌的女性。对患者进行随访直至 2008 年 12 月。估计一年、五年和十年的疾病特异性生存率。 Kaplan-Meier 和 Cox 回归模型用于分析乳腺癌死亡情况。结果：诊断时，70.2% 的肿瘤处于 I-II 期。在随访期间，发生了 705 例死亡，其中 58.4% 是死于乳腺癌。五年和十年乳腺癌特异性生存率分别为83.3%和73.7%（I期分别为97.1%和94.0%；II期分别为88.0%和79.4%；III期分别为70.1%和46.3%；IV期分别为24.5%和6.1%）。 5 年疾病特异性生存率从 1992-1995 年的 73.5% 增加到 2001-2005 年的 86.4%（对数等级，p < 0.001）。多变量分析显示，1992 年至 1995 年间诊断的女性、未通过筛查计划获得诊断的女性、年龄 >= 70 岁、患有 IV 期肿瘤、高度病变的女性以及仅接受姑息或对症治疗的女性，预后较差。调整预后因素后，外科医生的经验似乎并没有显着影响接受手术的女性的生存率。结论：从 1992 年到 2005 年，该中心的乳腺癌生存率显着提高。乳腺癌预后受到临床和组织变量的影响。对这些因素作用的量化为改善与研究医院类似的环境中的癌症护理提供了宝贵的知识。 (C) 2012 Elsevier Ltd. 保留所有权利。
Background: Data from a long-established hospital-based cancer registry were used to analyse the relationship between clinical and organisational factors and disease-specific survival among women with primary breast cancer.Methods: 2023 women with incident invasive breast cancer diagnosed from 1992 to 2005 were identified through the Hospital del Mar Cancer Registry (Barcelona, Spain). Patients were followed until December 2008. One-, 5- and 10-year disease-specific survival rates were estimated. Kaplan-Meier and Cox regression models were used to analyse death from breast cancer.Results: At diagnosis 70.2% of tumours were in stages I-II. During follow-up 705 deaths occurred, 58.4% specifically due to breast cancer. Five-and 10-year breast cancer specific survival rates were 83.3% and 73.7%, respectively (stage I, 97.1% and 94.0%; stage II, 88.0% and 79.4%; stage III, 70.1% and 46.3%, and stage IV, 24.5% and 6.1%, respectively). The 5-year disease-specific survival rate increased from 73.5% in 1992-1995 to 86.4% in 2001-2005 (log rank, p < 0.001). Multivariate analyses showed that prognosis was less favourable for women diagnosed between 1992 and 1995, for those whose route to diagnosis was not the screening programme, women aged >= 70 years, with stage IV tumours, with high grade lesions, and for women who received only palliative or symptomatic treatment. Adjusting for prognostic factors, surgeon's experience did not significantly appeared to affect survival of operated women.Conclusions: In this centre survival from breast cancer improved markedly from 1992 to 2005. Breast cancer prognosis was influenced by both clinical and organisational variables. The quantification of the role of such factors affords valuable knowledge to improve cancer care in settings similar to the study hospital. (C) 2012 Elsevier Ltd. All rights reserved.