T1-2N0乳腺癌乳房切除术后局部区域复发风险分层模型的建立

Risk-adaptedmodel for prediction oflocoregional recurrence in patients with T1-2N0 breast cancer aftermastectomy

目的:分析T1-2N0乳腺癌乳房切除术后局部区域复发的危险因素,并建立风险分层预后模型。方法:回顾性分析我院2015—2018年就诊的649例T1-2N0乳腺癌乳房切除术后患者的临床资料,筛选影响患者局部区域复发的独立预后因素,并根据危险因素的个数构建局部区域复发风险分层模型。结果:本组乳腺癌患者中位随访时间为59个月,5年总生存率、无远处转移生存率和局部区域复发率分别为99.2%、96.3%和2.7%。多因素分析提示,月经状况、肿瘤直径、病理分级是影响该组患者局部区域复发的独立预后因素(P<0.05)。进一步利用危险因素的个数构建风险分层模型,低危组(0~1个)、中危组(2个)和高危组(3个)的5年LRR分别为1.4%、6.3%和18.6%(P<0.0001)。结论:月经状况、肿瘤直径、病理分级是T1-2N0乳腺癌乳房切除术后患者局部区域复发的独立预后因素,其中同时具有3个危险因素可定义为局部区域复发高危人群。

Objective:To investigate the risk factors of locoregional recurrence and establishrisk-adaptedmodelinpatients with T1-2N0 breast cancer treated with mastectomy.Methods:From January 2015 to December 2018,a total of 649 T1-2N0breast cancer cases treated with mastectomy without adjuvant radiotherapy in the First Affiliated Hospital of Bengbu Medical Collegewere retrospectively analyzed,baseline characteristics of patients were analyzedand theindependent prognostic factors were used to establishrisk-adaptedmodel.Results:Themedian follow-up time was 59 months,the 5-year overall survival,distant metastasis free survival and locoregional recurrencerates were 99.2%,96.3%and 2.7%,respectively.Menopausal status,tumor size and histologic gradewere identified to be the independent prognostic factors of locoregional recurrenceby multivariate analysis,and the number of them was used to establish risk-adaptedmodel,the 5-year locoregional recurrence rates were 1.4%,6.3% and 18.6% in low-risk(0~1 risk factor),middle-risk(2 risk factors)and high-risk group(3 risk factors),there was significantly difference in locoregional recurrencerates among the three groups(P<0.000 1).Conclusion:Menopausal status,tumor size and histologic grade were theindependent prognostic factors affectinglocoregional recurrence of T1-2N0 breast cancer patients treated with mastectomy,the population with all of them can be defined as high risk subgroup of locoregional recurrence.