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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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.
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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.	陈路嘉, 叶长生. 趋化因子 CXCL13 是年轻乳腺癌预后不良的潜在危险因素. 南方医科大学, 2014.
14.	李铁灵, 郭海峰, 李华洋. 三阴性年轻乳腺癌患者 BRCA1、TopoⅡα、Bcl-2 表达和预后的关系. 现代肿瘤医学, 2016, 24(2): 231-233.
15.	李崎, 温力牧, 吴旻骅, 等. 不同年龄段三阴性乳腺癌患者临床病理特点与生存状况研究. 现代实用医学, 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.	黄涛, 刘慧. 三阴性乳腺癌药物治疗的研究进展. 中华乳腺病杂志(电子版), 2019, 13(4): 252-256.
18.	李静, 李丽茹, 宋英, 等. 三阴性乳腺癌免疫治疗的研究进展. 肿瘤学杂志, 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.	陈莉娜, 王欣. 老年三阴性乳腺癌的临床病理特征、治疗情况及预后分析. 天津医科大学, 2017.

1. 陈锡康, 田华琴. 三阴性乳腺癌的治疗现状及进展. 西部中医药, 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. 刘军玲, 周革, 郭宏斌. IL-6联合NLR对三阴性乳腺癌术后患者预后的预测价值. 中国医药导报, 2020, 17(8): 113-116.
4. 徐玲, 刘荫华. 乳腺癌国际指南与中国临床实践. 临床外科杂志, 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. 中国老年乳腺癌治疗共识专家组. 中国老年乳腺癌治疗专家共识(2018). 协和医学杂志, 2018, 9(4): 307-312.
7. 周洁, 陈萱, 陈钰, 等. 三阴性乳腺癌的治疗现状及进展. 医学研究生学报, 2018, 31(8): 853-858.
8. 倪晨, 李婷, 吴振华, 等. 三阴性乳腺癌化疗进展. 中国癌症杂志, 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. 陈路嘉, 叶长生. 趋化因子 CXCL13 是年轻乳腺癌预后不良的潜在危险因素. 南方医科大学, 2014.
14. 李铁灵, 郭海峰, 李华洋. 三阴性年轻乳腺癌患者 BRCA1、TopoⅡα、Bcl-2 表达和预后的关系. 现代肿瘤医学, 2016, 24(2): 231-233.
15. 李崎, 温力牧, 吴旻骅, 等. 不同年龄段三阴性乳腺癌患者临床病理特点与生存状况研究. 现代实用医学, 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. 黄涛, 刘慧. 三阴性乳腺癌药物治疗的研究进展. 中华乳腺病杂志(电子版), 2019, 13(4): 252-256.
18. 李静, 李丽茹, 宋英, 等. 三阴性乳腺癌免疫治疗的研究进展. 肿瘤学杂志, 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. 陈莉娜, 王欣. 老年三阴性乳腺癌的临床病理特征、治疗情况及预后分析. 天津医科大学, 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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