Sobrevida Libre de Enfermedad en Mujeres con Cáncer de Mama: Cohortes de 36 y 60 Meses
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n4.4726Palabras clave:
Neoplasias de la Mama/diagnóstico, Supervivencia, Pronóstico, Estudios de CohortesResumen
Introducción: El estudio de la sobrevida libre de enfermedad ha contribuido a conocer el comportamiento y los factores pronósticos tras el diagnóstico de cáncer de mama en mujeres. Objetivo: Analizar la sobrevida libre de enfermedad a los 36 y 60 meses y los factores pronósticos en mujeres con cáncer de mama atendidas en un servicio sanitario privado. Método: Estudio de cohortes histórico con una población dinámica de mujeres diagnosticadas con cáncer de mama no metastásico atendidas entre 2010 y 2021. Se recogieron datos demográficos y clínicos. Los análisis estadísticos fueron descriptivos, bivariados y de sobrevida mediante el método de Kaplan-Meier y la prueba log-rank. Resultados: La sobrevida libre de enfermedad a los 36 meses fue del 89,8% (IC 95%: 84,8-93,3) y el estadio clínico III fue el de peor pronóstico, con una reducción del 11% del tiempo medio en comparación con el estadio I. En comparación con los 60 meses, la supervivencia libre de enfermedad fue del 80,6% (IC 95%: 73,1-86,2), siendo los estadios II y III los de peor pronóstico. La reducción del tiempo medio para el estadio III fue del 21% en comparación con el estadio I. Conclusión: Las características tumorales y clínicas son importantes para comprender la sobrevida libre de enfermedad e identificar perfiles de riesgo de recurrencia, dada la escasez de investigaciones sobre el tema en la población brasileña. Por tanto, se destaca la necesidad de un diagnóstico temprano para reducir la recurrencia.
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Instituto Nacional de Câncer José Alencar Gomes da Silva. A situação do câncer de mama no Brasil: síntese de dados dos sistemas de informação. Rio de Janeiro: INCA; 2019.
Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: cancer today [Internet]. Lyon: International Agency for Research on Cancer; 2024 [acesso 2024 out 20]. Disponível em: https://gco.iarc.fr/today
Atlas On-line de Mortalidade [Internet]. Rio de Janeiro: Instituto Nacional de Câncer José Alencar Gomes da Silva. c1996-2014 - [acesso 2024 out 12]. Disponível em https://mortalidade.inca.gov.br/
Azamjah N, Soltan-Zadeh Y, Zayeri F. Global trend of breast cancer mortality rate: a 25-year study. Asian Pac J Cancer Prev. 2019;20(7):2015-20. doi: https://doi.org/10.31557/apjcp.2019.20.7.2015 DOI: https://doi.org/10.31557/APJCP.2019.20.7.2015
Couto MSA, Guerra MR, Firme VAC, et al. Comportamento da mortalidade por câncer de mama nos municípios brasileiros e fatores associados. Rev Panam Salud Pública. 2017;41:1. doi: https://doi.org/10.26633/rpsp.2017.168 DOI: https://doi.org/10.26633/RPSP.2017.168
Ayala ALM, Anjos JC, Cassol GA, et al. Sobrevida em 10 anos em mulheres com câncer de mama: coorte história de 2000-2014. Ciênc saúde coletiva. 2019;24(4):1537-50. doi: https://doi.org/10.1590/1413-81232018244.16722017 DOI: https://doi.org/10.1590/1413-81232018244.16722017
Borges GS, Colchon PH, Júnior MCS, et al. Análise da sobrevida livre de doença e sobrevida global em pacientes com câncer de mama luminal A. Rev Bras Oncol Clin. 2011;7(26):18-26.
Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023-75. doi: https://doi.org/10.1016/s0140-6736(17)33326-3 DOI: https://doi.org/10.1016/S0140-6736(17)33326-3
Machado KK, Katz A, Buyse M, et al. Sobrevida global e outros desfechos clínicos em câncer de mama: situação atual e controvérsias. Rev Assoc Med Bras. 2010;56(5):514-6. doi: https://doi.org/10.1590/S0104-42302010000500008 DOI: https://doi.org/10.1590/S0104-42302010000500008
Diniz RW, Guerra MR, Cintra JRD, et al. Disease-free survival in patients with non-metastatic breast cancer. Rev Assoc Med Bras. 2016;62(5):407-13. doi: https://doi.org/10.1590/1806-9282.62.05.407 DOI: https://doi.org/10.1590/1806-9282.62.05.407
Peres VC, Veloso DLC, Xavier RM, et al. Breast cancer in women: recurrence and survival at five years. Texto contexto - enferm. 2015;24(3):740-7. doi: https://doi.org/10.1590/0104-07072015000600014 DOI: https://doi.org/10.1590/0104-07072015000600014
Guerra MR, Mendonça GAS, Bustamante-Teixeira MT, et al. Sobrevida de cinco anos e fatores prognósticos em coorte de pacientes com câncer de mama assistidas em Juiz de Fora, Minas Gerais, Brasil. Cad Saúde Pública. 2009;25(11):2455-66. doi: https://doi.org/10.1590/S0102-311X2009001100015 DOI: https://doi.org/10.1590/S0102-311X2009001100015
Schneider IJC, d’Orsi E. Sobrevida em cinco anos e fatores prognósticos em mulheres com câncer de mama em Santa Catarina, Brasil. Cad Saúde Pública. 2009;25(6):1285-96. doi: https://doi.org/10.1590/S0102-311X2009000600011 DOI: https://doi.org/10.1590/S0102-311X2009000600011
Rothman KJ, Greenland S, Lash TL, et al. Modern epidemiology. 2. ed. Philadelphia: Lippincott-Raven; 1998. 737 p.
Vandenbroucke JP, Pearce N. Incidence rates in dynamic populations. Int J Epidemiol. 2012;41(5):1472-9. doi: https://doi.org/10.1093/ije/dys142 DOI: https://doi.org/10.1093/ije/dys142
Le-Rademacher J, Wang X. Time-to-event data: an overview and analysis considerations. J Thorac Oncol. 2021;16(7):1067-74. doi: https://doi.org/10.1016/j.jtho.2021.04.004 DOI: https://doi.org/10.1016/j.jtho.2021.04.004
StataR [Internet]. Versão 16.1. Lakeway: StataCorp LLC; 1996–2024c. [acesso 2023 nov 20]. Disponível em: https://www.stata.com/
Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção I:59.
Carmo PO, Leite ICG, Guerra MR. Sobrevida de mulheres com câncer de mama subtipo luminal assistidas em Juiz de Fora, MG. Rev Bras Mastol (Impr). 2016;26(3):118-25. doi: https://doi.org/10.5327/Z201600030007RBM DOI: https://doi.org/10.5327/Z201600030007RBM
Simons JM, Jacobs JG, Roijers JP, et al. Disease-free and overall survival after neoadjuvant chemotherapy in breast cancer: breast-conserving surgery compared to mastectomy in a large single-centre cohort study. Breast Cancer Res Treat. 2021;185(2):441-51. doi: https://doi.org/10.1007/s10549-020-05966-y DOI: https://doi.org/10.1007/s10549-020-05966-y
Nowikiewicz T, Wiśniewska M, Wiśniewski M, et al. Overall survival and disease-free survival in breast cancer patients treated at the Oncology Centre in Bydgoszcz –analysis of more than six years of follow-up. Contemp Oncol (Pozn). 2015;19(4):284-9. doi: https://doi.org/10.5114/wo.2015.54387 DOI: https://doi.org/10.5114/wo.2015.54387
Pruessmann J, Pursche T, Hammersen F, et al. Conditional disease-free and overall survival of 1,858 young women with non-metastatic breast cancer and with participation in a post-therapeutic rehab programme according to clinical subtypes. Breast Care (Basel). 2021;16(2):163-72. doi: https://doi.org/10.1159/000507315 DOI: https://doi.org/10.1159/000507315
Brierley JD, Gospodarowicz M, Wittekind CH, editors. TNM Classification of Malignant Tumours. 8. ed. Chichester, West Sussex: Wiley Blackwell; 2017. DOI: https://doi.org/10.1002/9780471420194.tnmc26.pub3
Amin MB, editor. AJCC cancer staging manual. 8 ed. Chicago: American Joint Committee on Cancer Springer; 2017. 1024 p.
Dong G, Wang D, Liang X, et al. Factors related to survival rates for breast cancer patients. Int J Clin Exp Med. 2014;7(10):3719-24.
Chen CC, Tang WH, Wu CC, et al. Pretreatment circulating albumin, platelet, and RDW-SD associated with worse disease-free survival in patients with breast cancer. Breast Cancer (Dove Med Press). 2024;2024(16):23-39. doi: https://doi.org/10.2147/BCTT.S443292 DOI: https://doi.org/10.2147/BCTT.S443292
Louis D, Mathew M, Gutjahr G, et al. Survival outcomes of breast cancer patients in South India over 20 years. Asian Pacific J Cancer Prevention. 2024;25(8):2633-44. doi: https://doi.org/10.31557/APJCP.2024.25.8.2633 DOI: https://doi.org/10.31557/APJCP.2024.25.8.2633
Trabulus FDC, Nazli MA, Arslan E, et al. Predictors of recurrence in breast cancer patients with pathological partial response. Rev Assoc Med Bras (1992). 2024;70(3):e20231215. doi: https://doi.org/10.1590/1806-9282.20231215 DOI: https://doi.org/10.1590/1806-9282.20231215
Mrabti H, Sauvaget C, Bendahhou K, et al. Breast cancer treatment and its impact on survival in Morocco: a study over a decade. BMC Cancer. 2024;24(1):786. doi: https://doi.org/10.1186/s12885-024-12570-6 DOI: https://doi.org/10.1186/s12885-024-12570-6
Morrison DH, Rahardja D, King E, et al. Tumour biomarker expression relative to age and molecular subtypes of invasive breast cancer. Br J Cancer. 2012;107(2):382-7. doi: https://doi.org/10.1038/bjc.2012.219 DOI: https://doi.org/10.1038/bjc.2012.219
Kheirelseid EA, Boggs JM, Curran C, et al. Younger age as a prognostic indicator in breast cancer: a cohort study. BMC Cancer. 2011;11(1):383. doi: https://doi.org/10.1186/1471-2407-11-383 DOI: https://doi.org/10.1186/1471-2407-11-383
Azim HA, Partridge AH. Biology of breast cancer in young women. Breast Cancer Res. 2014;16(4):427. doi: https://doi.org/10.1186/s13058-014-0427-5 DOI: https://doi.org/10.1186/s13058-014-0427-5
Buzdar AU, Suman VJ, Meric-Bernstam F, et al. Disease-free and overall survival among patients with operable HER2-positive breast cancer treated with sequential vs concurrent chemotherapy: the ACOSOG Z1041 (Alliance) randomized clinical trial. JAMA Oncol. 2019;5(1):45-50. doi: https://doi.org/10.1001/jamaoncol.2018.3691 DOI: https://doi.org/10.1001/jamaoncol.2018.3691
Han W, Kim SW, Ae Park I, et al. Young age: an independent risk factor for disease-free survival in women with operable breast cancer. BMC Cancer. 2004;4(82):1-8. doi: https://doi.org/10.1186/1471-2407-4-82 DOI: https://doi.org/10.1186/1471-2407-4-82
Gnerlich JL, Deshpande AD, Jeffe DB, et al. Elevated breast cancer mortality in young women (<40 years) compared with older women is attributed to poorer survival in early stage disease. J Am Coll Surg. 2009;208(3):341-7. doi: https://doi.org/10.1016/j.jamcollsurg.2008.12.001 DOI: https://doi.org/10.1016/j.jamcollsurg.2008.12.001
Lian W, Fu F, Lin Y, et al. The impact of young age for prognosis by subtype in women with early breast cancer. Sci Rep. 2017;7(1):11625. doi: https://doi.org/10.1038/s41598-017-10414-x DOI: https://doi.org/10.1038/s41598-017-10414-x
Caparlar MA, Dokcu S, Erogu A. Significance of immunohistochemical markers in women with breast cancer. Niger J Clin Pract. 2023;26(3):314-8. doi: https://doi.org/10.4103/njcp.njcp_252_22 DOI: https://doi.org/10.4103/njcp.njcp_252_22
Tasci HI. Clinical and pathological differences of breast cancer in younger and elderly patients. Ann Ital Chir. 2023;94:131-1
Zhao XR, Tang Y, Wu HF, et al. Influence of age as a continuous variable on the prognosis of patients with pT1-2N1 breast cancer. Breast. 2022;66:136-44. doi: https://doi.org/10.1016/j.breast.2022.08.005 DOI: https://doi.org/10.1016/j.breast.2022.08.005
Li CL, Wu CC, Kan JY, et al. The impact of age group in breast cancer survival outcome according to neoadjuvant treatment response: a matched case-control study. Kaohsiung J Med Sci. 2022;38(3):277-82. doi: https://doi.org/10.1002/kjm2.12475 DOI: https://doi.org/10.1002/kjm2.12475
Ding W, Ruan G, Lin Y, et al. Dynamic changes in marital status and survival in women with breast cancer: a population-based study. Sci Rep. 2021;11(1):5421. doi: https://doi.org/10.1038/s41598-021-84996-y DOI: https://doi.org/10.1038/s41598-021-84996-y
Osborne C, Ostir GV, Du X, et al. The influence of marital status on the stage at diagnosis, treatment, and survival of older women with breast cancer. Breast Cancer Res Treat. 2005;93(1)41-7. doi: https://doi.org/10.1007/s10549-005-3702-4 DOI: https://doi.org/10.1007/s10549-005-3702-4
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