Clinical and pathological factors influencing survival in a large cohort of triple-negative breast cancer patients

被引：76

作者：

Urru, Silvana Anna Maria ^{[1
]}

Gallus, Silvano ^{[2
]}

Bosetti, Cristina ^{[3
]}

Moi, Tiziana ^{[4
]}

Medda, Ricardo ^{[1
]}

Sollai, Elisabetta ^{[4
]}

Murgia, Alma ^{[4
]}

Sanges, Francesca ^{[5
]}

Pira, Giovanna ^{[6
]}

Manca, Alessandra ^{[7
]}

Palmas, Dolores ^{[8
]}

Floris, Matteo ^{[1
]}

Asunis, Anna Maria ^{[9
]}

Atzori, Francesco ^{[10
]}

Carru, Ciriaco

D'Incalci, Maurizio ^{[3
]}

Ghiani, Massimo ^{[8
]}

Marras, Vincenzo ^{[7
]}

Onnis, Daniela ^{[9
]}

Santona, Maria Cristina ^{[11
]}

Sarobba, Giuseppina ^{[12
]}

Valle, Enrichetta ^{[8
]}

Canu, Luisa ^{[11
]}

Cossu, Sergio ^{[11
]}

Bulfone, Alessandro ^{[1
]}

Rocca, Paolo Cossu ^{[5
]}

De Miglio, Maria Rosaria ^{[5
]}

Orru, Sandra ^{[4
]}

机构：

[1] Ctr Adv Studies Res & Dev Sardinia CRS4, Biomed Sect, Technol Pk Polaris, Cagliari, Italy

[2] IRCCS, Ist Ric Farmacol Mario Negri, Dept Epidemiol, Via G La Masa 19, I-20156 Milan, Italy

[3] IRCCS, Ist Ric Farmacol Mario Negri, Dept Oncol, Milan, Italy

[4] A Businco Oncol Hosp, ASL, Dept Pathol, Cagliari, Italy

[5] Univ Sassari, Dept Clin & Expt Med, Sassari, Italy

[6] Univ Sassari, Dept Biomed Sci, Sassari, Italy

[7] AOU, Dept Pathol, Sassari, Italy

[8] A Businco Oncol Hosp, ASL, Dept Med Oncol, Cagliari, Italy

[9] Brotzu Hosp, Dept Pathol, Cagliari, Italy

[10] AOU, Med Oncol Unit, Cagliari, Italy

[11] ASL Nuoro, Dept Pathol, Nuoro, Italy

[12] ASL Nuoro, Dept Med Oncol, Nuoro, Italy

来源：

BMC CANCER | 2018年 / 18卷

关键词：

Clinicopathologic factors; Prognostic factors; Stage; Survival; Triple-negative breast cancer; TUMOR-INFILTRATING LYMPHOCYTES; LYMPH-NODE RATIO; PROGNOSTIC VALUE; KI67; RECURRENCE; PATTERNS; RECOMMENDATIONS; FEATURES; SUBTYPES; OUTCOMES;

D O I：

10.1186/s12885-017-3969-y

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: To provide further information on the clinical and pathological prognostic factors in triple-negative breast cancer (TNBC), for which limited and inconsistent data are available. Methods: Pathological characteristics and clinical records of 841 TNBCs diagnosed between 1994 and 2015 in four major oncologic centers from Sardinia, Italy, were reviewed. Multivariate hazard ratios (HRs) for mortality and recurrence according to various clinicopathological factors were estimated using Cox proportional hazards models. Results: After a mean follow-up of 4.3 years, 275 (33.3%) TNBC patients had a progression of the disease and 170 (20.2%) died. After allowance for study center, age at diagnosis, and various clinicopathological factors, all components of the TNM staging system were identified as significant independent prognostic factors for TNBC mortality. The HRs were 3.13, 9.65, and 29.0, for stage II, III and IV, respectively, vs stage I. Necrosis and Ki-67 > 16% were also associated with increased mortality (HR: 1.61 and 1.99, respectively). Patients with tumor histotypes other than ductal invasive/lobular carcinomas had a more favorable prognosis (HR: 0.40 vs ductal invasive carcinoma). No significant associations with mortality were found for histologic grade, tumor infiltrating lymphocytes, and lymphovascular invasion. Among lymph node positive TNBCs, lymph node ratio appeared to be a stronger predictor of mortality than pathological lymph nodes stage (HR: 0.80 for pN3 vs pN1, and 3.05 for >0.65 vs <0.21 lymph node ratio), respectively. Consistent results were observed for cancer recurrence, except for Ki-67 and necrosis that were not found to be significant predictors for recurrence. Conclusions: This uniquely large study of TNBC patients provides further evidence that, besides tumor stage at diagnosis, lymph node ratio among lymph node positive tumors is an additional relevant predictor of survival and tumor recurrence, while Ki-67 seems to be predictive of mortality, but not of recurrence.

引用

页数：11

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