伊朗妇女乳腺癌患者复发(早期和晚期)和死亡的预后因素

M. Akbari, A. Akbari, N. Nafissi, Zeinab Shormeij, S. Sayad, M. R. Rasaf, Leyla Shojaee
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引用次数: 6

摘要

背景:乳腺癌治疗的成功取决于通过有效的治疗延长生存期,并持续监测复发。通过更好地了解预后因素、预防措施和有效的治疗以及随访和治疗后护理,可以很好地提高生存率。目的:本研究旨在了解影响伊朗乳腺癌患者复发和死亡的预后因素。方法:回顾性分析1982年10月至2014年3月在Shahid Beheshti医科大学癌症研究中心收治的1604例女性乳腺癌患者的资料。在随访中,确诊后复发的313例患者分为早期复发组、不到1年复发组和5年后晚期复发组。我们分析了各组复发的预后因素,并评估了该患者的有效死亡因素。结果:患者诊断时的中位年龄为50岁。中位随访时间为4.33年(范围:0.005-24.9年)。其中210例(67.09%)和76例(24.28%)发生远处和局部复发。313例患者中,62例(21/60%)和69例(24/04%)有早期和晚期复发。单因素分析中,肿瘤分级、疾病分期、ER和PR状态、腋窝淋巴结受累和淋巴血管侵犯是影响患者复发的预后因素;多因素分析中,ER/PR状态是影响早期复发最重要的独立预后因素,疾病分期是影响晚期复发的预后因素。随访结束时,复发患者生存率为56.86%(178例),死亡人数为43.13%(135例)。最重要的死亡因素是组织学分级、无病生存时间、复发部位和疾病年龄。结论:生物标志物雌激素和孕激素受体状态对早期复发影响最大,不同于晚期复发,疾病分期起更重要的作用。然而,淋巴血管浸润是早期或晚期复发的有效因素。通过对这些患者死亡的影响因素的研究,发现复发部位、DFS、病理分级和患者复发时的年龄是有效的。了解更多影响复发和复发患者死亡的因素,可以通过采取更有效的治疗方法来提高患者的生存率和生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostic Factors of Recurrence (Early and Late) and Death in Breast Cancer Patients in Iranian Women
Background: Breast cancer treatment success depends upon prolonging survival with effective treatment, and constant monitoring of recurrence. Survival rate can well be improved by better understanding of prognostic factors, preventive measures, and effective treatments together with follow-up and post-treatment care. Objectives: This study is aimed to know prognostic factors effective in recurrence and death in Iranian breast cancer patients. Methods: This is a retrospective study conducted by reviewing data acquired from 1604 female breast cancer patients who were admitted to Cancer Research Center at Shahid Beheshti University of Medical Sciences between October, 1982 and March, 2014. During the follow-up, after diagnosis, 313 patients experienced recurrence then were classified into two groups: early recurrence, less than 1 year and late recurrence after 5 years. We analyzed prognostic factors of recurrence in each groups and evaluated effective factors of death in this patients. Results: Median age of patients at diagnosis was 50 years. Median follow up time was 4.33 years (range: 0.005-24.9 years). Of these patients, 210 (67.09 %) and 76 (24.28%), developed distant and loco -regional recurrence. Among 313 patients, 62 (21/60%) and 69 (24/04%) had early and late recurrence. In the univariate analysis, tumor grade, stage of disease, ER and PR status, axillary lymph node involvement and lymph vascular invasion were the prognostic factors affecting recurrence in patients, but in the multivariate analysis, ER/PR status was the most important independent prognostic factor affecting the early recurrence and stage of disease were prognostic factors in late recurrence. In all of the recurrent patients, 56.86% (178 individuals) survived and 43.13% (135 individuals) died at the end of follow-up period. The most important factors of death were histologic grade, disease free survival time, site of recurrence and age of disease. Conclusions: Biologic marker, estrogen and progesterone receptors status, had most influence in early recurrence, unlike late recurrence, stage of disease had a more important role. However, lymph vascular invasion has been an effective factor either in early or late recurrence. As a result of studying effective factors in death of these patients, recurrence site, DFS, pathologic grade and patients’ age at the time of recurrence came to be effective. Knowing more about affecting factors on recurrence and the death of patients with recurrence, one can try to enhance survival and quality of life in patients by adopting more effective treatments.
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