2015 年第 5 期 第 13 卷

乳腺癌术后胸壁转移患者的临床特征及预后因素分析

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关键词：乳腺癌胸壁转移临床-病理特征治疗预后因素

• 摘要：
• 【摘要】【摘要】目的 分析乳腺癌术后局部胸壁转移患者的临床特征、治疗方式及对预后的影响。方法 收集北京大学肿瘤医院乳腺肿瘤内科2014年收治的64例乳腺癌术后以胸壁复发为首发转移部位患者的临床资料，分析各项临床-病理因素同局部控制率及生存期之间的关系。并回顾万方及Pubmed数据库中的相关文献，进行参考及总结。结果 本组患者原发肿瘤术后无病生存期（DFS）为4-277个月，中位时间50个月。单纯胸壁转移患者局部复发后无进展生存期（PFS） 2-120个月，中位时间为21.5个月。单纯胸壁转移组单因素分析显示：患者的原发肿瘤病理类型、脉管癌栓情况、激素受体水平、Her-2受体表达情况是原发肿瘤术后DFS及OS的相关预后因素；多因素分析显示：原发肿瘤的病理类型、脉管癌栓情况、术后辅助放疗、辅助内分泌治疗及原发肿瘤术后DFS是总生存期的独立预后因素。结论 乳腺癌术后局部复发可增加远处转移及死亡风险，明确复发高风险因素，采取全身综合治疗及局部治疗可改善该类患者预后。
• 【Abstract】Objective: To analysis the clinical features, treatment methods and prognosis of breast cancer patients with chest wall recurrence(CWR) after mastectomy. Methods: During 2014, 64 patients with identified CWR were treated at our hospital. We collected their clinical-pathologic data, analyzed the relations of the various factors with local control and survival，and reviewed related literatures in the database of WANFANG and Pubmed. Results: Of the patients, the disease-free survival after operation was from 4 to 277 months, with a median survival time of 50 months. For simple chest wall recurrences patients, the survival time after chest wall recurrence was from 2 to 120 months, with a median survival time of 21.5 months. On univariate analysis, the pathological types, blood vessel invasion, hormone receptor status and Her-2 receptor status were associated with the DFS and overall survival of the patients. In multivariate analysis, the pathological types, blood vessel invasion, radiotherapy after operation, adjuvant endocrine therapy and the DFS after mastectomy were independent prognostic factors for the overall survival of the patients. Conclusion: Postoperative chest wall breast cancer recurrence can increase the risk of distant metastases and death, and systemic treatment combined local treatment can help improve the prognosis.