PDF(Pubmed)
Abstract：
BACKGROUND: Sentinel lymph node biopsy (SLNB) is a common choice for axillary surgery in patients with early-stage breast cancer (BC) who have clinically negative lymph nodes. Most research indicates that obesity is a prognostic factor for BC patients, but studies assessing its association with the rate of positive sentinel lymph nodes (SLN) and the prognosis of patients with early BC undergoing SLNB are limited.
METHODS: Between 2013 and 2016, 7062 early-stage BC patients from the Shanghai Cancer Center of Fudan University were included. Based on the Chinese Body Mass Index (BMI) classification standards, the patients were divided into three groups as follows: normal weight, overweight, and obese. Propensity score matching analysis was used to balance the baseline characteristics of the participants. Logistic regression analysis was used to determine the association between obesity and positive SLN rate. Cox regression analysis was used to investigate whether obesity was an independent prognostic factor for early-stage BC patients who had undergone SLNB.
RESULTS: No significant association was observed between obesity and positive SLN rate in early-stage BC patients who had undergone SLNB. However, multivariate analysis revealed that compared to patients with normal BMI, the overall survival (hazard ratio (HR) 2.240, 95% confidence interval (CI) 1.27-3.95, p = 0.005) and disease-free survival (HR 1.750, 95% CI 1.16-2.62, p = 0.007) were poorer in patients with high BMI.
CONCLUSIONS: Obesity is an independent prognostic factor for early-stage BC patients who undergo SLNB; however, it does not affect the positive SLN rate.
METHODS: Between 2013 and 2016, 7062 early-stage BC patients from the Shanghai Cancer Center of Fudan University were included. Based on the Chinese Body Mass Index (BMI) classification standards, the patients were divided into three groups as follows: normal weight, overweight, and obese. Propensity score matching analysis was used to balance the baseline characteristics of the participants. Logistic regression analysis was used to determine the association between obesity and positive SLN rate. Cox regression analysis was used to investigate whether obesity was an independent prognostic factor for early-stage BC patients who had undergone SLNB.
RESULTS: No significant association was observed between obesity and positive SLN rate in early-stage BC patients who had undergone SLNB. However, multivariate analysis revealed that compared to patients with normal BMI, the overall survival (hazard ratio (HR) 2.240, 95% confidence interval (CI) 1.27-3.95, p = 0.005) and disease-free survival (HR 1.750, 95% CI 1.16-2.62, p = 0.007) were poorer in patients with high BMI.
CONCLUSIONS: Obesity is an independent prognostic factor for early-stage BC patients who undergo SLNB; however, it does not affect the positive SLN rate.
摘要：
背景：前哨淋巴结活检（SLNB）是临床淋巴结阴性的早期乳腺癌（BC）患者进行腋窝手术的常用选择。大多数研究表明，肥胖是BC患者的预后因素，但评估其与前哨淋巴结(SLN)阳性率和接受SLNB的早期BC患者预后的相关性的研究有限.
方法：2013-2016年，复旦大学附属上海市肿瘤防治中心7062例早期BC患者纳入研究。基于中国人体重指数(BMI)分类标准,将患者分为以下三组:正常体重,超重,和肥胖。使用倾向评分匹配分析来平衡参与者的基线特征。采用Logistic回归分析确定肥胖与SLN阳性率的相关性。Cox回归分析用于研究肥胖是否是SLNB早期BC患者的独立预后因素。
结果：在接受SLNB的早期BC患者中，肥胖与SLN阳性率之间没有显著关联。然而,多因素分析显示,与BMI正常的患者相比,高BMI患者的总生存期(风险比(HR)2.240,95%置信区间(CI)1.27~3.95,p=0.005)和无病生存期(HR1.750,95%CI1.16~2.62,p=0.007)较差.
结论：肥胖是SLNB早期BC患者的独立预后因素；然而，不影响SLN阳性率。
方法：2013-2016年，复旦大学附属上海市肿瘤防治中心7062例早期BC患者纳入研究。基于中国人体重指数(BMI)分类标准,将患者分为以下三组:正常体重,超重,和肥胖。使用倾向评分匹配分析来平衡参与者的基线特征。采用Logistic回归分析确定肥胖与SLN阳性率的相关性。Cox回归分析用于研究肥胖是否是SLNB早期BC患者的独立预后因素。
结果：在接受SLNB的早期BC患者中，肥胖与SLN阳性率之间没有显著关联。然而,多因素分析显示,与BMI正常的患者相比,高BMI患者的总生存期(风险比(HR)2.240,95%置信区间(CI)1.27~3.95,p=0.005)和无病生存期(HR1.750,95%CI1.16~2.62,p=0.007)较差.
结论：肥胖是SLNB早期BC患者的独立预后因素；然而，不影响SLN阳性率。
