新辅助化疗联合保乳手术临床病理特征及预后分析

The clinicopathological features and prognosis analysis of neoadjuvant chemotherapy combined with breast-conserving surgery

目的分析新辅助化疗(NAC)联合保乳手术(BCT)的乳腺癌患者临床病理特征及预后。方法回顾性分析上海交通大学乳腺癌数据库(SJTU-BCDB)2010年至2015年NAC联合BCT患者的临床病理资料。通过Kaplan-Meier法的log-rank检验和COX回归模型进行生存分析。结果51例患者中11例(21.6%)出现复发或转移,其中6例出现局部复发,5例出现远处转移。3例(5.9%)因乳腺癌复发或转移死亡。单因素分析显示术后是否接受辅助放疗(P<0.001)及体重(P<0.001)与总生存(OS)时间显著相关;术后是否接受辅助放疗(P=0.033)、乳腺癌家族史(P=0.001)及初潮年龄(P=0.022)与无病生存(DFS)时间显著相关。多因素分析结果显示,乳腺癌家族史(HR:0.056,P=0.018)以及术后是否接受辅助放疗(HR:27.130,P=0.011)是影响NAC联合BCT患者DFS的独立危险因素。结论术后接受辅助放疗者DFS及OS均高于术后未接受辅助放疗者,有乳腺癌家族史对患者预后不利。

Objective To analyze the clinicopathological data and prognosis of patients who received neoadjuvant chemotherapy combined with breast-conserving surgery.Methods This was a retrospective study based on the clinicopathological data of breast cancer patients who received neoadjuvant chemotherapy combined with breast-conserving surgery from 2010 to 2015 in Shanghai Jiao Tong University breast cancer database(SJTU-BCDB).The survival analysis was performed by log-rank test and Cox regression model.Results Among 51 subjects,11(21.6%)had recurrence or metastasis,including 6 patients with local recurrence,5 patients with distant metastasis,and 3 patients(5.9%)died.Univariate analysis showed that postoperative adjuvant radiotherapy(P<0.001)and body mass index(P<0.001)were significantly correlated with overall survival(OS);postoperative adjuvant radiotherapy(P=0.033),family history of breast cancer(P=0.001)and menarche age(P=0.022)were significantly correlated with disease-free survival(DFS).Multivariate analysis showed that family history of breast cancer(HR:0.056,P=0.018)and postoperative adjuvant radiotherapy(HR:27.130,P=0.011)were independent risk factors for DFS.Conclusion DFS and OS of patients with postoperative adjuvant radiotherapy are higher than those without adjuvant radiotherapy.Family history of breast cancer is unfavorable to the prognosis of patients.