Outcomes in Nonmetastatic Hormone Receptor-Positive HER2-Negative Pure Mucinous Breast Cancer: A Multicenter Cohort Study.

IF 14.8 2区医学 Q1 ONCOLOGY

Journal of the National Comprehensive Cancer Network Pub Date : 2024-05-14 DOI:10.6004/jnccn.2023.7121

Ryan Ying Cong Tan, Whee Sze Ong, Kyung-Hun Lee, Seri Park, Jabed Iqbal, Yeon Hee Park, Jeong Eon Lee, Jong Han Yu, Ching-Hung Lin, Yen-Shen Lu, Makiko Ono, Takayuki Ueno, Yoichi Naito, Tatsuya Onishi, Geok-Hoon Lim, Su-Ming Tan, Han-Byoel Lee, Jiwon Koh, Wonshik Han, Seock-Ah Im, Veronique Kiak Mien Tan, Nitar Phyu, Fuh-Yong Wong, Puay Hoon Tan, Yoon-Sim Yap

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引用次数: 0

Abstract

Background: Although considered a favorable subtype, pure mucinous breast cancer (PMBC) can recur, and evidence for adjuvant therapy is limited. We aimed to compare outcomes of nonmetastatic PMBC with invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) to address these uncertainties.

Methods: Individual patient-level data from 6 centers on stage I-III hormone receptor-positive and HER2-negative PMBC, IDC, and ILC were used to analyze recurrence-free interval (RFI), recurrence-free survival (RFS), and overall survival (OS), and to identify prognostic factors for PMBC.

Results: Data from 20,684 IDC cases, 1,475 ILC cases, and 943 PMBC cases were used. Median follow-up was 6.6 years. Five-year RFI, RFS, and OS for PMBC were 96.1%, 94.9%, and 98.1%, respectively. On multivariable Cox regression, PMBC demonstrated superior RFI (hazard ratio [HR], 0.59; 95% CI, 0.43-0.80), RFS (HR, 0.70; 95% CI, 0.56-0.89), and OS (HR, 0.71; 95% CI, 0.53-0.96) compared with IDC. ILC showed comparable outcomes to IDC. Fewer than half (48.7%) of recurrences in PMBC were distant, which was a lower rate than for IDC (67.3%) and ILC (80.6%). In contrast to RFI, RFS events were driven more by non-breast cancer deaths in older patients. Significant prognostic factors for RFI among PMBC included positive lymph node(s) (HR, 2.42; 95% CI, 1.08-5.40), radiotherapy (HR, 0.44; 95% CI, 0.23-0.85), and endocrine therapy (HR, 0.25; 95% CI, 0.09-0.70). No differential chemotherapy associations with outcomes were detected across PMBC subgroups by nodal stage, tumor size, and age. A separate SEER database analysis also did not find any association of improved survival with adjuvant chemotherapy in these subgroups.

Conclusions: Compared with IDC, PMBC demonstrated superior RFI, RFS, and OS. Lymph node negativity, adjuvant radiotherapy, and endocrine therapy were associated with superior RFI. Adjuvant chemotherapy was not associated with better outcomes.

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非转移性激素受体阳性 HER2 阴性纯黏液性乳腺癌的疗效：一项多中心队列研究。

背景：尽管纯粘液性乳腺癌（PMBC）被认为是一种有利的亚型，但它可能复发，而且辅助治疗的证据有限。我们旨在比较非转移性PMBC与浸润性导管癌（IDC）和浸润性小叶癌（ILC）的治疗效果，以解决这些不确定因素：来自6个中心的I-III期激素受体阳性和HER2阴性PMBC、IDC和ILC的患者个体水平数据被用来分析无复发间隔期（RFI）、无复发生存期（RFS）和总生存期（OS），并确定PMBC的预后因素：结果：采用了20684例IDC、1475例ILC和943例PMBC的数据。中位随访时间为 6.6 年。PMBC的五年RFI、RFS和OS分别为96.1%、94.9%和98.1%。经多变量考克斯回归，PMBC的RFI（危险比[HR]，0.59；95% CI，0.43-0.80）、RFS（HR，0.70；95% CI，0.56-0.89）和OS（HR，0.71；95% CI，0.53-0.96）均优于IDC。ILC的结果与IDC相当。PMBC中不到一半（48.7%）的复发是远处复发，这一比例低于IDC（67.3%）和ILC（80.6%）。与RFI相比，RFS事件更多是由老年患者的非乳腺癌死亡引起的。PMBC患者RFI的重要预后因素包括淋巴结阳性（HR，2.42；95% CI，1.08-5.40）、放疗（HR，0.44；95% CI，0.23-0.85）和内分泌治疗（HR，0.25；95% CI，0.09-0.70）。在按结节分期、肿瘤大小和年龄划分的PMBC亚组中，未发现化疗与预后之间存在差异。一项单独的SEER数据库分析也未发现在这些亚组中辅助化疗与生存率的提高有任何关联：结论：与IDC相比，PMBC的RFI、RFS和OS均优于IDC。淋巴结阴性、辅助放疗和内分泌治疗与较高的RFI相关。辅助化疗与更好的疗效无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the National Comprehensive Cancer Network ONCOLOGY-

CiteScore

20.20

自引率

0.00%

发文量

388

审稿时长

4-8 weeks

期刊介绍： JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care. Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.