Correlation Analysis of Myelosuppression after Chemotherapy for Triple-Negative Breast Cancer and Its Prognosis
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20240424.002
- VernacularTitle:三阴性乳腺癌化疗后骨髓抑制与其预后的相关性分析
- Author:
Kunjian XIA
1
;
Lin WANG
;
Zhenhua SUN
Author Information
1. 九江学院第二附属医院普通外科,江西 九江 332005;南昌大学第二附属医院乳腺外科,江西 南昌 330006
- Keywords:
triple negative breast cancer;
adjuvant chemotherapy;
myelosuppression;
disease-free survival;
overall survival
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2024;45(3):475-483
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To investigate whether severe myelosuppression after chemotherapy is associated with progno-sis in patients with breast cancer.[Methods]Triple negative breast cancer(TNBC)patients who received chemotherapy at the Second Affiliated Hospital of Nanchang University from May 2,2013 to May 2,2018 were divided into a control group(no/mild myelosuppression)and a case group(severe myelosuppression).In this study,251 patients with TNBC met the inclusion and exclusion criteria,including 125 patients in the control group(20 patients with grade 0 myelosuppression,43 patients with grade I myelosuppression,62 patients with grade Ⅱ myelosuppression),126 patients in the case group(114 patients with grade Ⅲ myelosuppression,12 patients with grade Ⅳ myelosuppression).The general clinicopathologi-cal data of the patients in the two groups,including age,pathological type of tumor,tumor T stage,tumor N stage,tumor Nottingham grade,intravascular cancer thrombus,were analyzed using the χ2 test.The disease-free survival(DFS)and overall survival(OS)of the two groups were analyzed using the Kaplan-Meier method.A Cox proportional hazards regres-sion model with multiple factors was used to analyze the impact of post-chemotherapy severe myelosuppression on disease-free survival(DFS)and overall survival(OS)in patients with TNBC.[Results]The differences in general clinicopatholog-ic data between the two groups of patients were not statistically significant(all P＞0.05).The 5-year disease-free survival(DFS)rate was significantly lower in the control group compared with the case group(75.2%vs.85.7%,P=0.027).How-ever,there was no statistically significant difference in the 5-year overall survival(OS)rate between the two groups(88.8%vs.95.2%,P=0.057).The analysis of the multifactorial Cox proportional hazards regression model revealed that post-chemotherapy severe myelosuppression was an independent protective factor for disease-free survival(DFS)(HR=0.332,95%CI:0.173-0.638,P=0.001)and overall survival(OS)(HR=0.193,95%CI:0.062-0.602,P=0.005)in TN-BC patients.[Conclusion]Our results show that TNBC patients with severe myelosuppression after chemotherapy have lon-ger disease-free survival(DFS)than those with no/mild myelosuppression,and overall survival(OS)also tend to be pro-longed compared with those with no/mild myelosuppression,and severe myelosuppression after chemotherapy can be used as an independent predictor of a good prognosis in breast cancer.
