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作 者:王斌[1,2,3,4] 连镇[1,2,3,4] 熊健[1,2,3,4] 杨艳芳[1,2,3,4] 方志沂[1,2,3,4]
机构地区:[1]天津医科大学肿瘤医院乳腺二科,300060 [2]国家肿瘤临床医学研究中心,300060 [3]天津市肿瘤防治重点实验室,300060 [4]乳腺癌防治教育部重点实验室,300060
出 处:《中华普通外科杂志》2015年第1期23-26,共4页Chinese Journal of General Surgery
摘 要:目的探讨男性乳腺癌(male breast cancer,MBC)患者的临床病理特点、治疗方法、生存及影响预后因素。方法回顾性分析102例男性乳腺癌患者的临床病理、治疗及生存资料。结果全组随访率100%,随访期为3~279个月,中位随访65个月。随访期间,全组共有49例复发,5年内复发者占71.4%(35/49)。其中有21例局部复发,28例出现远处转移。远处转移患者中肺转移8例、骨转移7例、肝转移9例、脑转移3例,其他少见转移部位包括软组织、肾上腺1例。全组5年无复发生存率和总生存率分别为54.3%和72.8%。单因素分析显示:肿瘤大小、腋窝淋巴结转移、临床分期和辅助化疗是影响男性乳腺癌患者无复发生存率和总生存率的预后因素。COX回归分析发现腋窝淋巴结转移(P=0.085)是影响患者DFS的独立预后因素,而肿瘤大小(P=0.041)和腋窝淋巴结转移(P=0.024)是影响患者OS的独立预后因素。结论早期诊断及以手术为主的综合治疗是提高男性乳腺癌患者疗效的关键。Objective To evaluate the clinicopathological features, treatments and prognostic factors of male breast cancer (MBC) patients. Methods Clinical data of 102 MBC patients with histopathology confirmation at Tianjin Medical University Cancer Hospital were retrospectively analyzed. Results All 102 cases got follow-up. The follow-up rate was 100%. The follow-up period was 3 - 279 months. The mean follow-up period was 65 months. During the follow-up period, recurrence was found in 21 cases, metastasis occurred in 28 cases (including pulmonary metastasis in 8, osseous metastasis in 7, hepatic metastasis in 9, brain metastasis in 3, and soft tissues and adrenal gland metastasis in 1 ). The 5-year disease free survival rate was 54. 3% and the 5-year overall survival rate was 72. 8%. Univariate analysis showed that tumor size, axillary lymph node status, TNM stage, chemotherapy influenced the disease free and overall survival. Multivariate Cox regression shows that axillary lymph node status (P = 0. 085 ) was the independent prognostic factor of disease free survival for MBC. Tumor size( P = 0. 041 ) and axillary lymph node ( P = 0. 024 ) status were independent prognostic factors of overall survival for MBC. Conclusions Early diagnosis and comprehensive treatment strategy consisting of radical mastectomy is essential to improve the survival of patients with MBC.
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