陈晴纪楠, 何珊珊, 丁泊文, 韩春勇, 尹健. 局部晚期乳腺癌行即刻乳房再造术的远期生存及预后因素研究[J]. 中国肿瘤临床, 2023, 50(12): 606-611. DOI: 10.12354/j.issn.1000-8179.2023.20221526
引用本文: 陈晴纪楠, 何珊珊, 丁泊文, 韩春勇, 尹健. 局部晚期乳腺癌行即刻乳房再造术的远期生存及预后因素研究[J]. 中国肿瘤临床, 2023, 50(12): 606-611. DOI: 10.12354/j.issn.1000-8179.2023.20221526
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Qingjinan Chen, Shanshan He, Bowen Ding, Chunyong Han, Jian Yin. Study on long term survival and prognostic factors in immediate breast reconstruction for locally advanced breast cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(12): 606-611. DOI: 10.12354/j.issn.1000-8179.2023.20221526
Citation: Qingjinan Chen, Shanshan He, Bowen Ding, Chunyong Han, Jian Yin. Study on long term survival and prognostic factors in immediate breast reconstruction for locally advanced breast cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(12): 606-611. DOI: 10.12354/j.issn.1000-8179.2023.20221526
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局部晚期乳腺癌行即刻乳房再造术的远期生存及预后因素研究

Study on long term survival and prognostic factors in immediate breast reconstruction for locally advanced breast cancer

    摘要
  • 摘要:
      目的  探讨局部晚期乳腺癌（locally advanced breast cancer，LABC）行即刻乳房再造术（immediate breast reconstruction，IBR）的肿瘤学安全性。
      方法  回顾性分析2001年9月至2016年3月于天津医科大学肿瘤医院被诊断为LABC并行IBR的114例患者的临床资料，分析总体生存（overall survival，OS）率、无局部复发生存（local recurrence-free survival，LRFS）率和无远处转移生存（distant metastasis-free survival，DMFS）率。采用Cox比例风险回归模型分析影响预后的因素。
      结果  中位随访时间为55.0个月，总队列5年OS率、LRFS率和DMFS率分别为78.9%（95%CI：69.1%～85.9%）、95.8%（95%CI：89.2%～98.4%）和78.9%（95%CI：69.1%～86.0%）。肿瘤直径>5 cm较肿瘤直径≤5 cm患者更易局部复发（P=0.023）。Cox比例风险回归模型多因素分析显示，肿瘤直径>5 cm（HR=3.60，95%CI：1.40～9.10，P=0.007）与淋巴结病理分期N3（HR=4.20，95%CI：1.60～11.0，P=0.004）是患者死亡的独立危险因素。
      结论  LABC行IBR术式的总体肿瘤学安全性可靠。肿瘤直径>5 cm或淋巴结病理分期为N3的LABC患者应慎行IBR。

     

    Abstract:
      Objective  To investigate the oncological safety of immediate breast reconstruction (IBR) for locally advanced breast cancer (LABC).
      Methods  Data from patients diagnosed with LABC and who underwent IBR between September 2001 and March 2016 at Tianjin Medical University Cancer Institute & Hospital were retrospectively reviewed. Overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were assessed. Prognostic factors were analyzed using the Cox proportional risk regression model.
      Results  A total of 114 patients were included. With a median follow-up of 50 months, the 5-year estimates of OS, LRFS, and DMFS were 78.9% (95% confidence interval CI: 69.1%–85.9%), 95.8% (95% CI: 89.2%–98.4%), and 78.9% (95% CI: 69.1%–86.0%), respectively. Tumors>5 cm in size were more likely to recur locally than those ≤ 5 cm (P=0.023). Cox multivariate modeling revealed that tumors>5 cm (hazard ratio HR =3.60 95% CI: 1.40–9.10; P=0.007) and lymph node (s) involvement (N3 stage) (HR=4.20 95% CI: 1.60–11.0; P=0.004) were independent risk factors for death.
      Conclusions  IBR was safe for patients with LABC; however, patients with tumors>5 cm or lymph node(s) involvement (N3 stage) should be treated with caution.

     

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