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论文摘要

复发转移性三阴乳腺癌患者进展后生存特征分析

Survival of Patients with Metastatic Recurrent Triple-negative Breast Cancer

作者:彭祖祥, 钟晓蓉, 王竹等

Author:PENG Zu-xiang, ZHONG Xiao-rong, WANG Zhu. et al

收稿日期:          年卷(期)页码:2016,47(4):541-546

期刊名称:四川大学学报(医学版)

Journal Name:JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION)

关键字:三阴乳腺癌 无疾病间隔期 脑转移 多模式治疗 预后分析

Key words:Triple-negative breast cancer Disease-free interval Brain metastasis Multi-modal therapy Prognosticanalysis

基金项目:

中文摘要

目的 分析复发转移性三阴乳腺癌(metastatic recurrent triple-negative breast cancer, mrTNBC)的生存特征并寻找独立影响患者生存的预后因素。方法 收集四川大学华西医院收治、经病理组织学证实、在治疗过程中或治疗完成后发生首次复发转移的三阴乳腺癌(triple-negative breast cancer, TNBC)患者的临床病理资料。进展后生存情况采用Kaplan-Meier方法进行分析,单因素预后分析采用log-rank检验,多因素预后分析采用Cox比例风险模型。结果 本研究共纳入142例患者,中位随访时间41.9月(5.1~189.5月),进展后中位生存时间22.0月。单因素分析结果显示:肿瘤直径大小、淋巴结状态、肿瘤TNM分期、无疾病间隔期(disease-free interval, DFI)、复发转移部位的个数、是否脑转移、是否肝转移和进展后治疗模式是进展后生存时间的影响因素。多因素分析结果提示,发生多部位进展( P=0.004)、DFI≤12月( P=0.010)、发生脑转移( P=0.037)和单模式治疗(single-modal therapy, SMT, P P=0.024),远处转移的患者也有相同的趋势(进展后3年生存率,58.1% vs. 29.3%, P=0.003)。结论 发生多部位进展、DFI短、发生脑转移均为影响mrTNBC患者生存的危险因素,MMT为其保护因素。

英文摘要

Objective To determine factors associated with the survival of patients with metastatic recurrent triple-negative breast cancer (mrTNBC). Methods Initial metastatic recurrent (during or after therapy) patients with triple-negative breast cancer (TNBC) confirmed by post-operate pathology in the West China Hospital of Sichuan University were followed up. The accumulative survival rates after recurrence were calculated using Kaplan-Meier method and differences were tested using log-rank tests. Cox proportional hazards regression analyses were performed to identify independent predictors of survival rates. Results A total of 142 patients were included in this study. They were followed up on average 41.9 months (range: 5.1-189.5 months), and had median post-recurrence survival time of 22.0 months.Tumor diameter, lymph node status, TNM stage, disease-free interval (DFI), numbers of recurrent lesions, brain metastasis, liver metastasis and the rapeutic patterns were associated with the survival of patients. The Cox proportional hazards regression model identified multi-lesions recurrence ( P=0.004), DFI≤12 months ( P=0.010),brain metastasis ( P=0.037) and single-modal therapy (SMT) ( P P=0.024). Similar results were also found in the patients with distant metastases (post-recurrence 3-year survival rate 58.1% for MMT versus 29.3% for SMT, P=0.003).Conclusion Multi-lesions recurrence, short DFI and brain metastasis are independent risk predictors, while MMT is a protective factor for the survival of patients with mrTNBC.

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