基于SEER数据库的原发性乳腺血管肉瘤临床病理特征及预后因素分析

Analysis of clinicopathologic features and prognosis of primary breast angiosarcoma based on SEER database

目的:探讨原发性乳腺血管肉瘤的临床病理特征、预后及相关影响因素。方法:根据入组和排除标准从SEER数据库中下载原发性乳腺血管肉瘤患者资料,对患者的临床病理特征与生存情况进行分析,并对预后的影响因素进行单因素和多因素Cox比例风险回归分析。结果:在纳入符合研究的166例原发性乳腺血管肉瘤患者中,55.4%(92/166)发生于53岁以下女性,75.9%(126/166)诊断时未发生转移,97.0%(161/166)接受手术治疗,34.3%(57/166)接受放疗,31.3%(52/166)接受化疗。全组患者1年总体生存率为85.47%,不同年龄、不同分期、不同分化程度、不同肿瘤直径、不同手术方式以及单/多原发肿瘤患者间的生存率有明显差异(均P<0.05)。单因素分析显示,年龄、肿瘤分化程度、分期、多原发癌、手术方式、高肿瘤负荷是影响原发性乳腺血管肉瘤患者生存预后的相关因素(均P<0.05)。多因素分析显示,高龄、肿瘤分化差、分期晚、多原发癌、肿瘤直径是影响血管肉瘤患者预后的独立危险因素(均P<0.05)。结论:原发性血管肉瘤预后差,早期诊治和手术干预可降低肿瘤的进展并改善预后;辅助放疗和化疗对患者预后无显著影响。

Objective:To investigate the clinicopathologic features and prognosis as well as the relevant influential factors of primary breast angiosarcoma.Methods:According to the inclusion and exclusion criteria,the data of patients with primary breast angiosarcoma were downloaded from the SEER database.The clinicopathologic characteristics and survival status of the patients were analyzed.The influential factors for prognosis were determined by univariate and multivariate Cox regression analysis.Results:Of the selected 166 patients with primary breast angiosarcoma,55.4%(92/166)were women under53 years old,75.9%(126/166)had no metastasis at diagnosis,97.0%(161/166)underwent surgery,34.3%(57/166)received radiotherapy,and 31.3%(52/166)received chemotherapy.The 1-year overall survival rate of the entire group was 85.47%.The survival rates were significantly different among patients with different ages,stages,degrees of differentiation and tumor sizes and undergoing different surgical procedures as well as between patients with single primary tumor and multiple primary tumors(all P<0.05).Univariate analysis showed that age,differentiation,stage,multiple primary tumors,surgical procedure,and the maximum diameter of the lesion were significantly associated with the prognosis of the patients with primary breast angiosarcoma(all P<0.05).Multivariate analysis revealed that old age,poor differentiation,advanced stage,multiple primary cancers,and high tumor load were independent risk factors for prognosis of the patients with primary breast angiosarcoma(all P<0.05).Conclusion:Primary breast angiosarcoma has an unfavorable prognosis,and early diagnosis and treatment of primary breast angiosarcoma can reduce tumor progression and improve prognosis.Adjuvant radiotherapy and chemotherapy exert no significant effect on prognosis of the patients.