재발성 유방암 환자의 생존율 및 예후인자

Abstract

Purpose: Although significant advances in survival have been achieved with administering adjuvant treatments in patients with early breast carcinoma, patients with recurrent breast carcinoma usually die of their disease. There have been only a few reports on the prognostic factors of patients with recurrent disease. Methods: Two hundred thirty nine patients were treated by this institute from 1987 to 2002. We excluded those patients who had distant metastasis within three months of primary surgery. Recurrences were diagnosed by the physical findings, image study and/or tissue biopsy. The analyzed parameters were age, the primary tumor size, the nodal status, the TNM stage, the operation method, the estrogen receptor status, the disease free interval and the site of recurrence. The univariate survival distributions were estimated by using the method of Kaplan and Meier and they were compared by using the log rank test. The potential prognostic factors were analyzed via multivariate analysis with using Cox’s proportional hazard model. Results: The median survival time from first relapse was 19.2 months and the 2 year survival rate from recurrence was 55.7%. Univariate analysis showed that patients with negative nodal involvement, an early disease stage, positivity for estrogen receptor, a long disease free interval and nonvisceral site recurrence had significantly longer survival than the counterpart patients. Multivariate analysis showed that these factors were all independent factors with a similar relative risk, about 2.01 to 2.54. Conclusion: Thought the number of patients included in this study is relative small, our data clearly show that an axillary lymph node status, stage, estrogen receptor positivity, a disease free interval and the metastatic site are closely associated with survival from the first recurrence.