Comparison of clinicopathological features and treatments between young (≤40 years) and older (>40 years) female breast cancer patients in West China: A retrospective, epidemiological, multicenter, case only study
Wang K.,Xi'an Jiaotong University |
Ren Y.,Xi'an Jiaotong University |
Li H.,Chongqing Medical University |
Zheng K.,Chongqing Medical University |
And 10 more authors.
PLoS ONE | Year: 2016
The incidence of young cases of breast cancer is higher in China compared to the western world. We aimed to explore differences in risk factors, clinicopathological features and treatment modes of young female breast cancer compared to older patients in West China. We collected clinical information from 12,209 female breast cancer patients in West China, including risk factors, clinicopathological features and treatment modes, from January 2010 to December 2012. Chi-square tests and the multivariate logistic regression analysis were applied for statistical analysis. There were 2,682 young (≤40 years) cases and 9,527 older cases at the time of breast cancer diagnosis. Young patients had a greater tumor diameter at diagnosis, and a higher probability of axillary lymph node and distant metastasis (P < 0.05). The progesterone receptor positive expression rate, estrogen receptor/progesterone receptor double positive expression rate, and human epidermal growth factor receptor 2 (HER2) negative expression rate was higher in young patients compared to older patients (P < 0.05). For young patients, the age at menarche was earlier, they had lower marriage rates, fewer pregnancies and births, and a lower breastfeeding rate (P < 0.05). A higher proportion of young patients underwent advanced operations, neoadjuvant and adjuvant chemotherapy, radiotherapy, and endocrine therapy compared to older patients (P < 0.05). We found significant differences in the clinicopathological features, risk factors and treatment modes between young (≤40 years) and older (>40 years) female breast cancer patients in West China. As some of these results differ from those found in the western female population, it is likely that the mechanism of tumorigenesis of young female breast cancer patients in West China may differ from that in western developed countries. Further investigation into the regional differences in breast cancer tumorigenesis is warranted. © 2016 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Liu Q.,Peking Union Medical College |
Ding X.,Peking Union Medical College |
Yang J.,Peking Union Medical College |
Cao D.,Peking Union Medical College |
And 6 more authors.
Gynecologic Oncology | Year: 2013
Objective To evaluate the clinical significance of fertility-preserving comprehensive staging surgery (CSS) in the treatment of malignant ovarian germ cell tumors (MOGCTs). Methods A total of 92 cases of MOGCTs were retrospectively reviewed. Results Forty-six patients (50%) received CSS, which includes ipsilateral adnexectomy + omentectomy + retroperitoneal lymphadenectomy (appendectomy and multiple biopsies as required). Forty-six patients (50%) received USO, which includes ipsilateral adnexectomy + clinical intraoperative evaluation (including retroperitoneal lymph nodes, great omentum, peritoneal, and contralateral ovary), biopsy of suspicious sites, and excision of all visible lesions. The mean operation time (177.0 vs. 114.8 min; p < 0.0001) and the mean intraoperative blood loss (499.1 ml vs. 112.9 ml; p = 0.04) were significantly higher in the CSS group compared to those in the USO group. The complication rate (17.4% vs 0%, p = 0.003), the relapse rate (10.9% vs 2.2%, p = 0.102) and the mortality rate (4.3% vs 2.2%, p = 0.500) were higher in the CSS group compared to those in the USO group. The difference in complication rate was statistically significant. The overall 5 year survival rates were 92% and 97% in the CSS and USO groups, respectively (p = 0.575). Tumor-free survival rates at 5 years were 87% and 97% in the CSS and USO groups, respectively (p = 0.115). Conclusions The benefit of fertility-preserving CSS to MOGCT patients was not greater than that of USO. It is safer and more effective to perform ipsilateral adnexectomy + clinical intraoperative exploration surgery (including retroperitoneal lymph nodes, great omentum, peritoneal, and contralateral ovary), biopsy of suspicious sites, excision of all visible lesions, and adjuvant chemotherapy. © 2013 Elsevier Inc.
Xie H.,Sichuan Province Tumor Hospital |
Zhou H.,Sichuan Province Tumor Hospital |
Zhou J.,Sichuan Province Tumor Hospital |
Wang L.,Sichuan Province Tumor Hospital |
And 2 more authors.
Chinese Journal of Clinical Oncology | Year: 2014
Objective: To study the clinical features and risk factors of death within the first chemotherapy cycle in multiple myeloma (MM). Methods: From 2004 to 2012, 111 patients with MM received first-line chemotherapy. Their clinical data were recorded and analyzed retrospectively. Results: A total of 15 patients died within six months after diagnosis, whereas 10 patients (9%) died within the first chemotherapy cycle. The median overall survival was five days. The monoclonal protein isotype of 10 patients was as follows: light chain only, 7; IgG, 3.8 of 10 cases of deaths were attributed to infection and complications. Univariate analysis revealed that light-chain myeloma, thrombocytopenia, leukopenia, neutropenia before treatment, high ECOG score,and high serum creatinine were predictors of death within the first chemotherapy cycle. Logistic regression modeling identified light-chain myeloma (P=0.003, OR 12.976, 95% CI: 2.328 to 72.322), thrombocytopenia (P=0.034, OR 6.141, 95% CI: 1.152 to 32.739), and neutropenia (P=0.003, OR 13.639, 95% CI: 2.398 to 77.564) as independent predictors. Conclusion: Fatal risk could be elevated by the first cycle of chemotherapy in some patients with MM. The causes of death within the first chemotherapy cycle were mainly serious infection and complications. The prognostic factors of MM could not effectively predict the mortality risk of induction chemotherapy. Light-chain myeloma, thrombocytopenia, and neutropenia were independent predictors of death within the first chemotherapy cycle.