154例复发转移晚期乳腺癌的临床特点及随访分析

Clinical characteristics and follow-up of 154 recurrent and metastatic/advanced breast cancer patients

目的探讨复发转移和(或)晚期乳腺癌的临床病程及特点,分析影响预后的可能因素。方法回顾性分析2005年1月1日至2011年12月31日收治的复发转移和(或)晚期乳腺癌患者154例的临床特点及预后。结果全组患者中位无病生存时间(DFS)为21.3个月,62.8%的患者在确诊乳腺癌的3年内发生复发转移,单发转移者96例(62.3%),多发转移者58例(37.7%)。全组患者中位随访51个月。死亡59例(41.8%),中位无进展生存时间(PFS)为11个月,中位MSR为27个月。1、2、3、5年生存率分别为85.8%、74.5%、70.9%和67.4%。结论初始治疗转移后生存时间疗效及稳定期、首次复发转移时KPS评分、HER-2状态、内分泌治疗情况、是否三阴性乳腺癌与预后有关,首次复发转移时间与预后无明显关系,但首发转移部位及数目与预后有关。

Objective To survey the clinical course and characteristics,possible prognosis influencing factors of recurrent and metastatic / advanced breast cancer.Methods Female recurrent and metastatic /advanced breast cancer patients were treated in our hospital between January 2005 and December 2011 were taken retrospectively into the study.The clinical,pathological and survival data of them were analyzed.Results The median diseases free survival（DFS） of the whole group was 21.3 months.The recurrent and metastatic rate within 3 years was 62.8%,while the single rate was 62.3%,the multi-recurrent and metastatic rate was 37.7%.The median follow-up of the whole group was 51 months.The death rate was41.8%,The median progression free survival（PFS） and post metastasis survival（MSR） of the whole group was 11 months and 27 months respectively.The survival rates decreased yearly,with 85.8% of the first year,74.5% and 70.9% and 67.4% of the following three years.Conclusions Due to the current comprehensive analysis,the effect of chemotherapy and the interval of disease free survival,Karnofsky performance score of the first recurrent and metastatic patients,HER-2 expression status,used or not used hormonal therapy,triple negative breast cancer were relevant predictors of poor survival.Also,the prognosis was relevant to the place and number of the first metastasis organs,but no relevant to the DFS.The long-term followup should be pay more attension.