Analysis of postoperative prognostic factors of elderly patients with triple-negative breast cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Xinzhu ,  ZUO Huaiquan

Department of Breast Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;

Corresponding?author：

ZUO Huaiquan, Email: 13982772996@163.com

Keywords：

triple-negative breast cancer; elderly patient; pathological features; prognosis analysis

DOI：

10.7507/1007-9424.202006021

Video：

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Objective To analyze the clinicopathologic features of elderly patients with triple-negative breast cancer (TNBC) and explore the influencing factors of postoperative prognosis.Methods The TNBC patients who were pathologically confirmed in the Affiliated Hospital of Southwest Medical University from January 1st, 2013 to January 1st, 2014 were retrospectively collected. The differences of clinicopathologic characteristics bwteeen elderly and young and middle-aged patients (according to the standard of 65 years old) were analyzed. At the same time, Cox risk regression model was used to analyze the prognostic factors of elderly patients with TNBC.Results A total of 142 patients with TNBC were collected, including 53 elderly patients and 89 young and middle-aged patients. There were no significant differences in terms of family history, histological grade, clinical TNM stage, T stage, axillary lymph node status, and postoperative chemotherapy between the elderly patients and young and middle-aged patients (P>0.05). The rate of breast conserving surgery in the young and middle-aged patients was higher than that in the elderly patients (χ²=4.665, P=0.031). All patients were followed up to 60 months, the recurrence and metastasis rate and the mortality of the elderly patients were lower than those of the young and middle-aged patients (recurrence and metastasis rate: 30.2% versus 47.2%, χ²=3.974, P=0.046; mortality: 11.3% versus 28.1%, χ²=5.474, P=0.019), and the 5-year disease-free survival rate and 5-year overall survival rate of the elderly patients were higher than those of the young and middle-aged patients (5-year disease-free survival rate: 69.8% versus 52.8%, χ²=4.106, P=0.037; 5-year overall survival rate: 88.7% versus 71.9%, χ²=5.209, P=0.022). The tumor T stage (χ²=14.806, P=0.001) and status of axillary lymph node metastasis (χ²=8.149, P=0.043) were associated with postoperative recurrence and metastasis in the elderly patients with TNBC by univariate analysis, and which were the independent risk factors for the recurrence and metastasis in the elderly patients with TNBC by multivariate analysis.Conclusions Prognosis of elderly patients with TNBC is better than that of young and middle-aged patients. Tumor T stage and axillary lymph node status are independent risk factors affecting prognosis of elderly patients with TNBC.

Citation： LIU Xinzhu, ZUO Huaiquan. Analysis of postoperative prognostic factors of elderly patients with triple-negative breast cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(3): 341-344. doi: 10.7507/1007-9424.202006021 Copy

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12.	Anders CK, Hsu DS, Broadwater G, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol, 2008, 26(20): 3324-3330.
13.	陳路嘉, 葉長生. 趨化因子 CXCL13 是年輕乳腺癌預后不良的潛在危險因素. 南方醫科大學, 2014.
14.	李鐵靈, 郭海峰, 李華洋. 三陰性年輕乳腺癌患者 BRCA1、TopoⅡα、Bcl-2 表達和預后的關系. 現代腫瘤醫學, 2016, 24(2): 231-233.
15.	李崎, 溫力牧, 吳旻驊, 等. 不同年齡段三陰性乳腺癌患者臨床病理特點與生存狀況研究. 現代實用醫學, 2019, 31(3): 292-295, 封2.
16.	Ma D, Jiang YZ, Xiao Y, et al. Integrated molecular profiling of young and elderly patients with triple-negative breast cancer indicates different biological bases and clinical management strategies. Cancer, 2020, 126(14): 3209-3218.
17.	黃濤, 劉慧. 三陰性乳腺癌藥物治療的研究進展. 中華乳腺病雜志(電子版), 2019, 13(4): 252-256.
18.	李靜, 李麗茹, 宋英, 等. 三陰性乳腺癌免疫治療的研究進展. 腫瘤學雜志, 2020, 26(1): 13-17.
19.	Bergen ES, Tichy C, Berghoff AS, et al. Prognostic impact of breast cancer subtypes in elderly patients. Breast Cancer Res Treat, 2016, 157(1): 91-99.
20.	陳莉娜, 王欣. 老年三陰性乳腺癌的臨床病理特征、治療情況及預后分析. 天津醫科大學, 2017.

1. 陳錫康, 田華琴. 三陰性乳腺癌的治療現狀及進展. 西部中醫藥, 2018, 31(11): 135-140.
2. Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res, 2007, 13(15 Pt 1): 4429-4434.
3. 劉軍玲, 周革, 郭宏斌. IL-6聯合NLR對三陰性乳腺癌術后患者預后的預測價值. 中國醫藥導報, 2020, 17(8): 113-116.
4. 徐玲, 劉蔭華. 乳腺癌國際指南與中國臨床實踐. 臨床外科雜志, 2019, 27(3): 181-183.
5. Huang Z, Wen W, Zheng Y, et al. Breast cancer incidence and mortality: trends over 40 years among women in Shanghai, China. Ann Oncol, 2016, 27(6): 1129-1134.
6. 中國老年乳腺癌治療共識專家組. 中國老年乳腺癌治療專家共識(2018). 協和醫學雜志, 2018, 9(4): 307-312.
7. 周潔, 陳萱, 陳鈺, 等. 三陰性乳腺癌的治療現狀及進展. 醫學研究生學報, 2018, 31(8): 853-858.
8. 倪晨, 李婷, 吳振華, 等. 三陰性乳腺癌化療進展. 中國癌癥雜志, 2014, 24(4): 316-320.
9. Gregório AC, Lacerda M, Figueiredo P, et al. Therapeutic implications of the molecular and immune landscape of triple-negative breast cancer. Pathol Oncol Res, 2018, 24(4): 701-716.
10. Jenkins EO, Deal AM, Anders CK, et al. Age-specific changes in intrinsic breast cancer subtypes: a focus on older women. Oncologist, 2014, 19(10): 1076-1083.
11. Swanick CW, Lei X, Xu Y, et al. Long-term patient-reported outcomes in older breast cancer survivors: a population-based survey study. Int J Radiat Oncol Biol Phys, 2018, 100(4): 882-890.
12. Anders CK, Hsu DS, Broadwater G, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol, 2008, 26(20): 3324-3330.
13. 陳路嘉, 葉長生. 趨化因子 CXCL13 是年輕乳腺癌預后不良的潛在危險因素. 南方醫科大學, 2014.
14. 李鐵靈, 郭海峰, 李華洋. 三陰性年輕乳腺癌患者 BRCA1、TopoⅡα、Bcl-2 表達和預后的關系. 現代腫瘤醫學, 2016, 24(2): 231-233.
15. 李崎, 溫力牧, 吳旻驊, 等. 不同年齡段三陰性乳腺癌患者臨床病理特點與生存狀況研究. 現代實用醫學, 2019, 31(3): 292-295, 封2.
16. Ma D, Jiang YZ, Xiao Y, et al. Integrated molecular profiling of young and elderly patients with triple-negative breast cancer indicates different biological bases and clinical management strategies. Cancer, 2020, 126(14): 3209-3218.
17. 黃濤, 劉慧. 三陰性乳腺癌藥物治療的研究進展. 中華乳腺病雜志(電子版), 2019, 13(4): 252-256.
18. 李靜, 李麗茹, 宋英, 等. 三陰性乳腺癌免疫治療的研究進展. 腫瘤學雜志, 2020, 26(1): 13-17.
19. Bergen ES, Tichy C, Berghoff AS, et al. Prognostic impact of breast cancer subtypes in elderly patients. Breast Cancer Res Treat, 2016, 157(1): 91-99.
20. 陳莉娜, 王欣. 老年三陰性乳腺癌的臨床病理特征、治療情況及預后分析. 天津醫科大學, 2017.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of postoperative prognostic factors of elderly patients with triple-negative breast cancer

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