新辅助化疗结束至手术的时间对乳腺癌患者生存期的影响

目的探讨新辅助化疗结束至手术的间隔时间(TTS)对乳腺癌患者术后生存期的影响。方法回顾性分析2013年1月至2018年12月422例乳腺癌患者的临床资料。根据TTS将患者分为三组:A组:TTS<21 d,119例;B组:TTS21~28d,152例;C组:TTS>28d,151例。收集患者的临床资料并进行随访,采用Kaplan-Meier法估计生存时间并制作生存曲线,Log rank检验比较组间生存率差异。Cox比例风险模型分析TTS对患者生存时间的影响。结果患者中位TTS为26 d。A组、B组和C组无病生存期(P=0.012)和总生存期(P=0.015),差异有统计学意义。A组与B组间无病生存期(P=0.595)、总生存期(P=0.716),差异无统计学意义。A组和C组无病生存期(P=0.006)和总生存期(P=0.014)差异有统计学意义,B组和C组无病生存期(P=0.024)和总生存期(P=0.027),差异也有统计学意义。经多元Cox比例风险模型调整混杂因素后,TTS>28d是无病生存期[HR 2.33,95%CI 1.44〜3.77,P=0.001]和总生存期[HR 2.78,95%CI 1.01〜7.68,P=0.038]的独立影响因素。结论新辅助化疗结束到手术的时间超过28 d会给患者生存时间带来不利影响。

Objective To investigate the effect of the time to surgery(TTS)from the end of neoadjuvant chemotherapy on the survival of breast cancer patients.Methods The medical records of 422 breast cancer patients treated in our hospital from January 2013 to December 2018 were retrospectively analyzed.According to TTS,the patients were divided into three groups:group A:119 padents(TTS≤21 days);group B:TTS 21~28 days,152 cases;group C:TTS≥28 days,151 cases.Medical records of the patients were collected and foUowed up.The differences of disease-free survival(DFS)and overaU survival(OS)among the three groups were calculated by Kaplan-Meier curve and Log rank test.Cox proportional risk model was used to investigate the influence of TTS on survival time of patients.Results The median TTS was 26 days(range 14~63 days).DFS of Group A,B and C(P=0.012)and OS(P=0.015)with statistically significant difference.There were no significant differences in DFS(P=0.595)and OS(P=0.716)between group A and B.There was no significant difference in DFS(P=0.595)and OS(P=0.716)between group A and group B.However,differences in DFS(P=0.006)and OS(P=0.014)between groups A and C were statistically significant,and there were statistically significant differences in DFS(P=0.024)and OS(P=0.027)between groups B and C.After adjusting for confounders,TTS>28 d was an independent influencing factor for DFS[HR 2.33,95%CI 1.44-3.77,P=0.001]and OS[HR 2.78,95%CI 1.01〜7.68,P=0.038].Conclusion More than 28 days from the end of neoadjuvant chemotherapy to surgery can have an adverse effect on patient survival.