ObjectiveTo compare the clinicopathological features of Luminal A breast cancer patients in early and middle stage, and locally advanced Luminal A breast cancer, then the influencing factors of disease-free survival (DFS) in locally advanced Luminal A breast cancer patients were further discussed.MethodsFrom January 2010 to December 2012, 295 Luminal A breast cancer patients who completed diagnosis, treatment, and follow-up in our hospital were retrospectively collected. According to TNM stage, 227 cases of early and middle breast cancer and 68 cases of locally advanced breast cancer were divided into two groups. Chi-square test or rank sum test was used to compare the clinicopathological characteristics of patients between the two groups, and log-rank test and Cox proportional risk regression model were used to explore the influencing factors of 5-year DFS situation in patients with locally advanced Luminal A breast cancer.ResultsT stage and N stage were later in locally advanced Luminal A breast cancer patients than that of the early and middle breast cancer patients (P<0.05), and the tumor grade was higher in locally advanced Luminal A breast cancer patients (P<0.05). The 5-year DFS rate was 87.8% (259/295). In this study, there were5 comprehensive treatment schemes as follows: neoadjuvant chemotherapy + surgery + radiotherapy + endocrine therapy, neoadjuvant chemotherapy + surgery + endocrine therapy, surgery + chemotherapy + radiotherapy + endocrine therapy, surgery + chemotherapy + endocrine therapy, and surgery + radiotherapy + endocrine therapy. The 5-year DFS rate of locally advanced Luminal A breast cancer patients was lower than that of the early and middle Luminal A breast cancer patients (76.5% vs. 91.2%, P=0.001). Univariate analysis showed that T stage (χ2=8.248, P=0.040), N stage (χ2=9.470, P=0.024), vascular invasion (χ2=4.211, P=0.031), and tumor grade (χ2=6.985, P=0.030) were the factors influencing the5-year DFS situation of locally advanced Luminal A breast cancer patients. Multivariate analysis showed that T staging (HR=5.062, P<0.001) and N staging (HR=7.075, P<0.001) were the influencing factors for 5-year DFS situation in locally advanced Luminal A breast cancer patients. The later the T stage and N stage, the worse the 5-year DFS situation.ConclusionsT stage and N stage are independent risk factors for prognosis of patients with locally advanced Luminal A breast cancer. Individualized comprehensive treatment program is an important guarantee for improving the 5-year DFS rate of this kind of patients.
ObjectiveTo use real-world data from a large sample of papillary thyroid microcarcinoma (PTMC) in the SEER database to investigate the impact of delayed treatment on survival outcomes. MethodsA total of 40 761 patients with PTMC eligible for the study from the SEER database of the National Cancer Institute of the United States during 2000–2019 were selected as the study objects and divided into 3 groups according to the different delayed treatment time (0, 0–6 months, >6 months). Kaplan-Meir method was used to plot the survival curve and calculate 5-year cumulative disease-specific survival (DSS) rate and overall survival (OS) rate. Cox proportional hazard regression model was used to analyze the relationship between delayed treatment time, DSS and OS in PTMC patients and the influencing factors of prognosis. ResultsAmong the 40 761 patients, 7 575 (18.58%) were males and 33 186 (81.42%) were females, most of whom were females. The patients ranged in age from 3 to 97 years old [ (51.1±13.9) years old], of which 24 043 (58.99%) were <55 years old and 16 718 (41.01%) were ≥55 years old. Received treatment immediately after diagnosis in 30 823 patients (75.62%), 9 734 patients (23.88%) received treatment within 6 months after diagnosis, 204 patients (0.50%) received treatment 6 months after diagnosis. There were significant differences in age, sex, race, lymph node stage, radiotherapy, surgical method, number of lesions and invasion of thyroid capsule among the 3 groups (P< 0.001). The survival analysis results of the 3 groups showed that the delayed treatment time had no effect on DSS and OS of PTMC patients (P>0.05). The multivariate Cox proportional hazard regression model analysis results showed that the patient’s age ≥55 years old, male, married, lymph node metastasis, radiotherapy, total thyroidectomy and thyroid capsule invasion were the risk factors affecting DSS and OS in PTMC patients (P<0.05), while delayed treatment was not risk factors for DSS and OS in PTMC patients (P>0.05). ConclusionDelayed treatment is not an independent risk factor for DSS and OS in patients with PTMC, and active monitoring is a safe alternative to surgery for some PTMCS.