Analysis Of Prognostic Factors In Patients With Postoperative Recurrent Advanced Breast Cancer

Objective: The prognostic factors were analyzed in137cases with postoperativerecurrent advanced breast cancer to clear the related factors affecting the survival ofadvanced breast cancer. Filter the independent prognostic factors of survival withpostoperative recurrent advanced breast cancer patients, so that we can achieve reasonabletreatment to improve survival rate and prolong survival time.Methods: The clinical data of137female patients with postoperative recurrentadvanced breast cancer who underwent treatment in first affiliated hospital of Dalia n medicaluniversity from January2006to December2010, were analyzed and three years follow-upretrospectively. Kaplan-Meier method was used to evaluate1,2,3-year survival rate anddraw survival curves, Log-Rank test of univariate analysis to clear clinical factors associatedwith1,2,3-year survival rate. Put the significant differences into the COX model regressionmethod and identify the independent prognostic factors of survival with postoperativerecurrent advanced breast cancer.Results: The median survival time was21.5months,1,2,3-year survival rate ofpatients with postoperative recurrent advanced breast cancer was74%,47%,33%respectively. Clinical factors were analyzed by Log-Rank test of univariate analysis, whoseresults showed that: T1, T2and T3stage, one-year survival rate was79%,71%,72%respectively, two-year survival rate was51%,44%,47%respectively, three-year survivalrate was36%,36%,25%respectively (P=0.175). N0, N1, N2and N3stage, one-yearsurvival rate was83%,69%,66%,75%respectively, two-year survival rate was60%,40%,41%,42%respectively, three-year survival rate was43%,20%,41%,29%respectively(P=0.070). I, II, III stage, which were TNM stage, one-year survival rate was93%,75%,68%respectively, two-year survival rate was50%,52%,40%respectively, three-yearsurvival rate was36%,32%,33%respectively (P=0.290). The hormone receptor positive vs negative, one-year survival rate was78%,60%respectively, two-year survival rate was55%,23%respectively, three-year survival rate was37%,23%respectively (P=0.005). Themolecular subtype Luminal A, Liminal B, HER-2and Basal-like, one-year survival rate was79%、76%、67%、57%respectively, two-year survival rate was57%、48%、25%、22%respectively, three-year survival rate was38%、33%、25%、22%respectively (P=0.005).The disease free interval longer than24months vs equal or less than24months，one-yearsurvival rate was82%,64%respectively, two-year survival rate was56%,36%respectively,three-year survival rate was43%,22%respectively (P=0.007). Premenopausal vspostmenopausal, the one-year survival rate was80%,71%respectively, two-year survivalrate was48%,46%respectively, three-year survival rate was29%,35%respectively(P=0.532). The nature of the metastatic sites, only bone metastasis vs visceral metastasis, theone-year survival rate was100%,71%respectively, two-year survival rate was100%,42%respectively, three-year survival rate was50%,32%respectively (P=0.025). UsingHT(hormone therapy) vs CT(chemotherapy) in first line, one-year survival rate was88%,72%respectively, two-year survival rate was75%,43%respectively, three-year survival ratewas42%,32%respectively (P=0.565). CT plus HT vs only CT, one-year survival rate was89%,58%respectively, two-year survival rate was69%,24%respectively, three-yearsurvival rate was54%,12%respectively (P<0.001). The number of chemotherapy lines,more than three lines vs equal or less than three lines, the one-year survival rate was97%,65%respectively, two-year survival rate was72%,38%respectively, three-year survival ratewas55%,26%respectively (P<0.001). Log-Rank test of univariate analysis show thathormone receptor status, molecular subtype, disease free interval, the nature of metastaticsites, treatment pattern and the number of chemotherapy lines were related to survival rate ofpatients with postoperative recurrent advanced breast cancer. COX model regression methodanalysis showed the independent prognostic factors with postoperative recurrent advancedbreast cancer were disease free interval, the nature of metastatic sites, treatment pattern andthe number of chemotherapy lines.Conclusions: The median survival time was21.5months,1,2,3-year survival rate ofpatients with postoperative recurrent advanced breast cancer was74%,47%,33%respectively. Log-Rank test of univariate analysis showed that hormone receptor status,molecular subtype, disease free interval, nature of metastatic sites, treatment pattern and thenumber of chemotherapy lines were related to survival rate of patients with postoperativerecurrent advanced breast cancer. The independent prognostic factors with postoperativerecurrent advanced breast cancer were disease free interval, the nature of metastatic sites, treatment pattern and the number of chemotherapy lines. The clinicians should find therational methods to intervene the adverse prognostic factors to improve survival rate andprolong survival time.