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Objective To investigate the clinical factors in breast cancer recurrence after surgery, and build a prognostic model predicted recurrence, and comparative analysis of recurrence in patients with different treatment methods for the prediction of breast cancer recurrence and relapse in patients with a reasonable choice of treatment methods must reference. Methods A retrospective statistical analysis of the clinical data integrity admitted Affiliated Tumor Hospital of Guangxi Medical University from January 1998 to December 2005, a total of 91 cases of breast cancer recurrence in patients with pathologically confirmed. Select the 91 cases fully documented cases of 14 clinical factors as the possible impact of recurrence of breast cancer observed indicators, the application of the COX risk model single factor and multivariate analysis to analyze 14 clinical parameters and recurrence relations prognostic index model and verify it. The recurrence of breast cancer patients according to recurrence position divided into local recurrence, local recurrence and distant metastasis, distant metastasis three groups, each group according to the different treatment of the comparative analysis of the survival rate. The results show that the results of a clinical prognostic factors of breast cancer recurrence and prognostic index model 1.COX risk model single factor analysis, menstruation, primary tumor size (diameter, segment diameter), clinical stage, ER, of Her- 2, chemotherapy, radiotherapy, endocrine therapy and lymph node metastasis (number of positive lymph nodes, lymph node-positive number of segments, lymph node metastasis rate) significantly associated with breast cancer recurrence (P lt; 0.05). When the the lymphadenectomy number of ≥ 10, the number of positive lymph nodes, lymph node-positive number of segments, the rate of lymph node metastasis in breast cancer recurrence was significantly associated (P lt; 0.05); 10, only lymph node metastasis when the number of lymph node dissection lt; The rate of recurrence was significantly related (P = 0.019), while the number of positive lymph nodes, number of positive lymph nodes segmentation with recurrence no significant correlation (P gt; 0.05). Other projects, the age profile (age, segmented age), tumor location, surgical approach, lymphadenectomy (lymph node dissection, lymph node dissection segments), PR in breast cancer recurrence after no significant correlation (P are gt ; 0.05). 2.COX risk model multivariate analysis showed that the clinical stage, Her-2, ER, radiotherapy, chemotherapy, endocrine therapy, is an independent prognostic factor (P lt; 0.05). 3 breast cancer recurrence prognostic index formula: PI = -1.224 1.623 * X 5 0.633 * X 11 -0.478 * X 9 -0.829 * X 12 -1.871 * X -0.457 * X 14 , proven prognostic index model can accurately reflect the breast cancer patients after recurrence risk. Second, patients with recurrence after re-treatment analysis of the survival rate of patients with local recurrence of breast cancer after significantly superior to distant metastasis and Bureau with distant metastases patients, the difference was statistically significant (P lt; 0.05); distant metastasis Bureau associated with survival in patients with distant metastasis was no significant difference (P = 0.152). The survival rate was significantly higher than two years after recurrence in patients with relapsed patients relapse within two years, and the difference was statistically significant (P = 0.043). 2 patients with local recurrence, local treatment (or plus systemic therapy) group, the median survival time was significantly higher than that of the untreated group and systemic therapy group, the difference was statistically significant (P lt; 0.05). Untreated group and the survival time of the systemic treatment group difference was not statistically significant (P = 0.074). Distant metastases in patients with systemic therapy supplemented by topical treatment group, the median survival time was significantly higher than the systemic treatment group and the untreated group, and systemic therapy group, the median survival time was also significantly higher than that of the untreated group, the difference among the three statistically significant (P lt; 0.05). Local recurrence with distant metastasis in patients with local palliative therapy plus systemic treatment group and systemic therapy group, the median survival time was significantly higher than that of untreated and only partial treatment group (P lt; 0.05); local palliative therapy plus systemic treatment group The median survival time was 18 months, systemic treatment group the median survival time was 12 months, former recurrence survival time is longer than the latter, but the difference was not statistically significant (P = 0.051). Conclusion 1. Primary tumor size, clinical stage, Her-2, lymph node metastasis and recurrence of breast cancer after a positive correlation, are risk factors, in several parameters reflect lymph node metastasis, lymph node metastasis rate than the number of positive lymph nodes The situation can better reflect the risk of recurrence; menstruation, ER, radiotherapy, chemotherapy, endocrine therapy and recurrence was negatively related to protective factors. Clinical stage, Her-2, ER, radiotherapy, chemotherapy, endocrine therapy is an independent prognostic factor reflecting the risk of breast cancer recurrence. Predict the recurrence of breast prognostic index for PI = * clinical stage -1.224 1.623 0.633 * of Her-2-0.478 * ER-0.829 * chemotherapy -1.871 * radiotherapy -0.457 * endocrine therapy, proven as predict breast cancer after surgery recurrence judgment based on clinical practice. 2 patients with local recurrence of breast cancer after treatment should be based on local treatment mainly appropriate auxiliary in systemic therapy; patients with distant metastases, treatment should be mainly to systemic treatment, such as may be supplemented by local metastases treatment efficacy is better. Local recurrence in patients with distant metastasis, local palliative therapy plus systemic treatment can significantly improve patients' quality of life, to be able to achieve better efficacy.
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