术后首发内脏转移三阴性乳腺癌患者的临床特点及预后分析

发布时间：2019-06-24 20:28

【摘要】：目的 :探讨术后首发内脏转移三阴性乳腺癌的临床病理特点、一线化疗的情况及可能影响预后的因素。方法 :回顾性分析复旦大学附属肿瘤医院肿瘤内科2011年1月1日—2013年6月30日收治的107例术后首发内脏转移三阴性乳腺癌患者的临床资料、一线化疗情况和生存情况,并分析对预后影响的因素。结果 :全组107例患者,浸润性导管癌101例(94.4%),其他病理类型或混合性6例(5.6%)。术后中位无病间期为14.4个月,内脏转移后1、2和3年的生存率分别为75.7%、41.1%和22.4%。一线含铂方案化疗的客观有效率为60.0%,中位无进展生存时间为8.6个月;非铂方案化疗的客观有效率为36.2%,中位无进展生存时间为5.1个月,两者客观有效率和无进展生存时间差异均有统计学意义(P=0.014和P=0.023);含铂方案的中位生存期为19.9个月,非铂方案的中位生存期为20.9个月,两者间差异无统计学意义(P=0.423)。单因素分析结果显示,是否行新辅助化疗、术后是否放疗、肿瘤大小、淋巴结转移情况、临床分期、无病间期、一线化疗最佳疗效、是否为多内脏转移、一线化疗无进展生存时间均与预后有关(P值均0.05)。多因素分析提示,是否行新辅助化疗和无病间期是影响术后首发内脏转移三阴性乳腺癌总生存期的独立预后因素(P值均0.05)。结论 :术后首发内脏转移三阴性乳腺癌患者的无病间期短,远期生存率低,一线化疗含铂方案是良好选择,是否行新辅助化疗和无病间期不超过1年可能是其转移后总生存的独立预后因素。
[Abstract]:Objective: To study the clinical and pathological features of first-time internal organ transfer three-negative breast cancer, the condition of first-line chemotherapy and the factors that may affect the prognosis. Methods: The clinical data, the first-line chemotherapy and the survival condition of 107 patients with first-line visceral metastasis in the first-line visceral metastasis from January 1,2011 to June 30,2013 were analyzed retrospectively, and the factors influencing the prognosis were analyzed. Results: There were 101 patients with invasive ductal carcinoma (94.4%), other pathological types or mixed 6 cases (5.6%). The median no-disease interval was 14.4 months, and the 1,2 and 3-year survival rates were 75.7%, 41.1% and 22.4%, respectively. The objective response rate of the first-line platinum-containing regimen was 60.0%, the median progression-free survival time was 8.6 months, the objective response rate of the non-platinum-based chemotherapy was 36.2%, the median progression-free survival time was 5.1 months, There was a significant difference in both objective and non-progression-free survival time (P = 0.014 and P = 0.023). The median survival time of the platinum-containing regimen was 19.9 months. The median survival time of the non-platinum regimen was 20.9 months, and there was no significant difference between them (P = 0.423). The results of the single factor analysis show that whether the neoadjuvant chemotherapy, the postoperative radiotherapy, the size of the tumor, the lymph node metastasis, the clinical stage, the disease-free interval, the best curative effect of the first-line chemotherapy, the multiple visceral metastasis, The survival time of the first-line chemotherapy was related to the prognosis (P <0.05). The multi-factor analysis suggested that whether the new adjuvant chemotherapy and the disease-free interval were independent prognostic factors that affected the overall survival of the first-time visceral metastasis in the first-time visceral metastasis (P <0.05). Conclusion: The short-term and long-term survival rate of the three-negative breast cancer patients with the first-line visceral metastasis is a good choice for the first-line chemotherapy, and whether the new adjuvant chemotherapy and the disease-free interval are not more than 1 year may be the independent prognostic factors of the overall survival after the metastasis.
【作者单位】：河南宏力医院肿瘤内科;浙江省东阳市人民医院肿瘤内科;复旦大学附属肿瘤医院肿瘤内科;复旦大学上海医学院肿瘤学系;
【基金】：上海市卫生和计划生育委员会面上资助项目(编号:201640069)~~
【分类号】：R737.9

【参考文献】