Risk factors analysis of Disease-Free Survival after modified radical mastectomy in 208 patients with T1-2N1M0 breast cancer

doi:10.3877/cma.j.issn.1674-3946.2020.06.020

Abstract

Abstract:

Objective

To investigate the risk factors of disease-free survival rate after modified radical mastectomy in patients with T1-2N1M0 stage breast cancer.

Methods

Retrospective analysis were performed in 208 patients with T1-2N1M0 breast cancer underwent modified radical mastectomy from January 2011 to November 2014. The endpoint of follow-up was November 2019 and 5-years survival, of patients metastasis and recurrence of tumors were analyzed, Statistical analysis were performed by using SPSS 22.0 software. Count data were expressed as % and were analyzed by using χ² test. The univariate and Cox multivariate regression models were used to analyze the risk factors of prognosis. A P value<0.05 was considered as statistically significant difference.

Results

In this study, 208 patients were followed up. Among them, 28 cases had metastatic or recurrence, 180 cases had no metastasis and recurrence, with the 5-year disease-free survival rate of 86.5%. The results of single factor analysis showed that the risk factors of prognosis of patients with T1-2N1M0 breast cancer undergoing modified radical mastectomy included age of <45, Histological grade III, postoperative radiotherapy and Ki-67≥30%, with statistically significant difference (P<0.05).

Conclusion

Age of <45y, histological grade III, postoperative radiotherapy and Ki-67≥30% are independent risk factors for recurrence and metastasis after modified radical mastectomy in patients with T1-2N1M0 stage breast cancer, which might increase the prognosis risk.

Key words: Breast neoplasms, Mastectomy, modified radical, Prognosis, Risk factors

Guogang Liang, Weili Gao, Qunxian Wang, Lili Lin, Doudou Wang. Risk factors analysis of Disease-Free Survival after modified radical mastectomy in 208 patients with T1-2N1M0 breast cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(06): 604-607.

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References 15

[1]	中国抗癌协会乳腺癌专业委员会．中国抗癌协会乳腺癌诊治指南与规范(2019年版)[J/CL]．中国癌症杂志，2019, 29(8): 609-680.
[2]	Gradishar WJ, Anderson BO, Balassanian R，et al.NCCN Guidelines Insights: Breast Cancer，Version 1[J]. J Natl Compr Canc Netw，2017, 15 (4): 433-451.
[3]	Bevers TB, Helvie M, Bonaccio E，et al.Breast Cancer Screening and Diagnosis, Version 3.2018，NCCN Clinical Practice Guidelines in Oncology[J]．J Natl Compr Canc Netw，2018, 16(11): 1362-1389.
[4]	王宁，刘硕，杨雷，等.2018全球癌症统计报告解读[J/CD]．肿瘤综合治疗电子杂志，2019, 5 (1): 87-97.
[5]	李明，王淑莲，房辉，等．早期中危乳腺癌根治术后局部区域复发风险分层和放疗选择的研究[J]．中华肿瘤杂志，2017, 39(11): 841-849.
[6]	Kast K, Link T, Friedrich K，et al.Impact of Breast Cancer Subtypes and Patterns of Metastasis on Outcome[J]．Breast Cancer Res Treat，2015, 150(3): 621-629.
[7]	杨雅洁，贡雪灏，刘霞，等．年轻和老年女性乳腺癌分子分型及临床病理对比分析[J]．广东医学，2019, 40(S1): 153-155, 159.
[8]	艾勇彪，张丹峰，李文仿，等．青年和老年乳腺癌病理特征及预后差异的分析[J]．现代肿瘤医学，2018, 26(23): 3764-3767.
[9]	Bell R, Barraclough R, Vasieva O．Gene Expression Meta-Analysis of Potential Metastatic Breast Cancer Markers[J]．Curr Mol Med，2017, 17 (3): 200-210.
[10]	郭俊字，黎骋．乳腺癌不同分子分型的临床病理特征及预后分析[J]．医学理论与实践. 2017, 30(3): 421-423.
[11]	Chen H, Lu W, Zhang Y, et al. A Bayesian network meta-analysis of the efficacy of targeted therapies and chemotherapy for treatment of triple-negative breast cancer[J]. Cancer Med, 2019, 8(1): 383-399.
[12]	向东华，齐创，李银枝，等．伴高危因素且未发生淋巴结转移的T(1-2)期乳腺癌术后患者放疗疗效及预后分析[J]．现代肿瘤医学，2018, 26(13): 2051-2053.
[13]	Constantinou C, Papadopoulos S, Karyda E, et al. Expression and Clinical Significance of PTEN, c-Kit, c-Met, c-Myc, ALK, CK5/6, CK17, p53, EGFR, Ki67, p63 in Triple-negative Breast Cancer-A Single Centre Prospective Observational Study[J]. In Vivo, 2018, 32(2): 303-311.
[14]	邓淼，刘江波，刘起鹏，等. CK5/6和Ki67表达与乳腺癌分子病理特征关系的临床分析[J/CD]．中华乳腺病杂志(电子版), 2015, 9(6): 380-386.
[15]	Pan YB, Yuan YF, Liu GS, et al. P53 and Ki-67 as prognostic markers in triple-negative breast cancer patients[J]．PLoS One, 2017, 12(2): e0172324.

临床特征		例数	5年复发转移(n＝28)	χ²值	P值
年龄		?	?	?	?
?	<45 y	95	22(78.6)	14.113	0.001
?	≥45 y	113	6(21.4)	14.113	0.001
月经状态		?	?	?	?
?	绝经	107	7(25.0)	9.057	0.003
?	未绝经	101	21(75.0)	9.057	0.003
BMI		?	?	?	?
?	≤24 kg/m²	112	16(57.1)	0.141	0.707
?	>24 kg/m²	96	12(42.9)	0.141	0.707
原发灶位置		?	?	?	?
?	外象限	109	12(42.9)	1.182	0.277
?	内＋中央象限	99	16(57.1)	1.182	0.277
病理类型		?	?	?	?
?	浸润性导管癌	169	28(100.0)	2.352	0.125
?	浸润性小叶癌	12	0
?	其他浸润性癌	27	0
组织学分级		?	?	?	?
?	Ⅰ级	81	6(21.4)	6.770	0.034
?	Ⅱ级	86	12(42.9)
?	Ⅲ级	41	10(35.7)
?	T分期	?	?	?	?
?	T1	104	9(32.1)	4.127	0.042
?	T2	104	19(67.9)	4.127	0.042
术后辅助化疗		?	?	?	?
?	有	145	21(75.0)	0.331	0.565
术后放疗		?	?	?	?
?	有	90	25(89.3)	27.911	0.001
内分泌治疗		?	?	?	?
?	有	145	16(57.1)	2.421	0.120
淋巴结转移数目		?	?	?	?
?	1个	80	9(32.1)	1.498	0.221
?	2个	80	10(35.7)
?	3个	48	9(32.1)
ER阳性		137	14(50.0)	3.622	0.057
PR阳性		145	16(57.1)	2.421	0.120
HER-2阳性		96	17(60.7)	2.760	0.097
Ki-67		?	?	?	?
?	<30	161	5(17.9)	65.594	0.001
?	≥30	47	23(82.1)	65.594	0.001

临床特征		例数	5年复发转移(n＝28)	χ²值	P值
年龄		?	?	?	?
?	<45 y	95	22(78.6)	14.113	0.001
?	≥45 y	113	6(21.4)	14.113	0.001
月经状态		?	?	?	?
?	绝经	107	7(25.0)	9.057	0.003
?	未绝经	101	21(75.0)	9.057	0.003
BMI		?	?	?	?
?	≤24 kg/m²	112	16(57.1)	0.141	0.707
?	>24 kg/m²	96	12(42.9)	0.141	0.707
原发灶位置		?	?	?	?
?	外象限	109	12(42.9)	1.182	0.277
?	内＋中央象限	99	16(57.1)	1.182	0.277
病理类型		?	?	?	?
?	浸润性导管癌	169	28(100.0)	2.352	0.125
?	浸润性小叶癌	12	0
?	其他浸润性癌	27	0
组织学分级		?	?	?	?
?	Ⅰ级	81	6(21.4)	6.770	0.034
?	Ⅱ级	86	12(42.9)
?	Ⅲ级	41	10(35.7)
?	T分期	?	?	?	?
?	T1	104	9(32.1)	4.127	0.042
?	T2	104	19(67.9)	4.127	0.042
术后辅助化疗		?	?	?	?
?	有	145	21(75.0)	0.331	0.565
术后放疗		?	?	?	?
?	有	90	25(89.3)	27.911	0.001
内分泌治疗		?	?	?	?
?	有	145	16(57.1)	2.421	0.120
淋巴结转移数目		?	?	?	?
?	1个	80	9(32.1)	1.498	0.221
?	2个	80	10(35.7)
?	3个	48	9(32.1)
ER阳性		137	14(50.0)	3.622	0.057
PR阳性		145	16(57.1)	2.421	0.120
HER-2阳性		96	17(60.7)	2.760	0.097
Ki-67		?	?	?	?
?	<30	161	5(17.9)	65.594	0.001
?	≥30	47	23(82.1)	65.594	0.001

临床特征	回归系数	Wald	HR(95%CI)	P值
年龄≥45岁	-1.276	4.155	0.279(0.082～4.068)	0.032
未绝经	0.265	0.291	1.304(0.497～3.420)	0.590
组织学III级	0.839	4.735	2.313(1.087～4.294)	0.030
T分期	-0.639	1.362	0.528(0.181～1.543)	0.243
术后放疗	1.654	6.160	5.227(1.416～19.296)	0.013
Ki-67≥30%	-0.832	1.369	0.435(0.222～0.851)	0.015

临床特征	回归系数	Wald	HR(95%CI)	P值
年龄≥45岁	-1.276	4.155	0.279(0.082～4.068)	0.032
未绝经	0.265	0.291	1.304(0.497～3.420)	0.590
组织学III级	0.839	4.735	2.313(1.087～4.294)	0.030
T分期	-0.639	1.362	0.528(0.181～1.543)	0.243
术后放疗	1.654	6.160	5.227(1.416～19.296)	0.013
Ki-67≥30%	-0.832	1.369	0.435(0.222～0.851)	0.015

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