初诊Ⅳ期乳腺癌的临床病理特征及预后分析

李芷君; 张杰; 张丽; 佟仲生

doi:10.3971/j.issn.1000-8578.2019.19.0543

初诊Ⅳ期乳腺癌的临床病理特征及预后分析

Clinicopathologic Characteristics and Prognosis of De Novo Metastatic Breast Cancer Patients

摘要

摘要:
目的分析初诊Ⅳ期乳腺癌的临床病理特征及预后特点，以期对临床诊疗及判断预后提供一定的经验。
方法回顾性分析2011年1月—2016年12月天津医科大学肿瘤医院收治的124例初诊Ⅳ期乳腺癌患者临床病理特征及生存情况，并对可能影响预后的特征进行单因素和多因素分析。亚组分析手术治疗对不同亚组人群预后的影响。
结果 124例初诊Ⅳ期乳腺癌患者中位年龄为53（26~77）岁，中位随访时间为29月，中位无进展生存时间（PFS）及中位总生存时间（OS）分别为14（10.6~17.4）和35（29.1~40.9）月，ER状态及原发肿瘤T分期为无进展生存和总生存的独立影响因素（P < 0.05）。
结论初诊Ⅳ期乳腺癌患者肿瘤负荷较大，并有较高的进展风险，姑息性手术治疗有可能改善HR+/HER2-、原发肿瘤较大的患者的预后，因此，根据需要进行积极的个体化治疗尤为重要。

Abstract:
Objective To analyze the clinicopathological characteristics and prognosis of de novo metastatic breast cancer(DnMBC) patients, so as to provide some guidance for clinical diagnosis and treatment.
Methods We retrospectively analyzed the clinicopathologic characteristics of 124 DnMBC patients treated in the Tianjin Medical University Cancer Hospital from January 2011 to December 2016. Univariate and multivariate analysis were carried out for the survival and prognosis. Subgroup analysis was performed to analyze the effect of surgical treatment on the prognosis of patients.
Results The median age at diagnosis of 124 patients was 53(26-77) years old. The median follow-up time was 29 months, the median progression-free survival PFS) and overall survival(OS) were 14(10.6-17.4) and 35(29.1-40.9) months, respectively. ER status and primary tumor stage were independent influence factors of PFS and OS(P < 0.05).
Conclusion The clinicopathological characteristics of DnMBC patients are more invasive, with a higher risk of progression. Palliative surgical treatment may improve the prognosis of HR+/HER2- patients with large primary tumor. Therefore, individualized treatment as needed is particularly important.

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