意大利的乳腺癌新辅助化疗：对2017年至2022年接受治疗的37215名患者进行的Senonetwork分析。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2024-08-30 DOI:10.1016/j.breast.2024.103790

A. De Luca , M.I. Amabile , F. Santori , S. Di Matteo , M. Tomatis , A. Ponti , F. Frusone , M. Taffurelli , C. Tinterri , L. Marotti , M. Calabrese , C. Marchiò , F. Puglisi , I. Palumbo , L. Fortunato , the Senonet Collaborative Group*

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引用次数: 0

摘要

背景：对 "现实世界 "中采用新辅助化疗（NACT）的情况研究甚少。本研究旨在探讨意大利的新辅助化疗率、随时间推移的趋势以及治疗选择的决定因素：Senonetwork是意大利公认的乳腺中心网络，它开发了一个自愿性的全国数据仓库，旨在监控和提高治疗质量。我们对2017年至2022年期间参与该项目的24家高容量乳腺中心治疗的58661名乳腺癌（BC）患者进行了回顾性分析：在排除子集后，分析了37215名原发性BC患者，其中32933人接受了原发性乳腺手术，4282人接受了NACT。从2017年到2022年，NACT的总体发生率有所上升，尤其是HR-/HER2+、三阴性和HR+/HER2+ BC（P 结论：NACT对乳腺癌患者后续治疗的影响是显而易见的：NACT对后续手术治疗的影响很大，并随着时间的推移不断发展，导致手术范围缩小。即使在高流量中心，NACT 的实施率仍存在很大差异。尽管在研究期间，NACT 的使用率有了显著提高，但这些结果还需要进一步改进。

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Neoadjuvant chemotherapy for breast cancer in Italy: A Senonetwork analysis of 37,215 patients treated from 2017 to 2022

Background

Adoption of neoadjuvant chemotherapy (NACT) in the “real world” has been poorly investigated. Aim of this study was to examine the rate of NACT in Italy, trends over time and determinants of therapeutic choices.

Methods

Senonetwork, the recognized network of Breast Centers in Italy, has developed a voluntary national data warehouse with the aim to monitor and improve treatments quality. A retrospective analysis was conducted among 58,661 breast cancer (BC) patients treated between 2017 and 2022 by 24 high-volume Breast Centers participating in the project.

Results

After subset exclusion, 37,215 primary BC patients were analysed, 32,933 underwent primary-breast-surgery and 4,282 underwent NACT. From 2017 to 2022, the overall NACT incidence increased particularly for HR-/HER2+, Triple-Negative, and HR+/HER2+ BC (p < 0.001). In cN + patients the recommendation to axillary lymph-node dissection after NACT decreased over time along with an increase of <4 lymph-nodes removed (p < 0.001). Immediate breast reconstruction and indication for nipple sparing mastectomy increased significantly over time (OR = 1.10, p = 0.011 and OR 1.14, p < 0.001, respectively). On multivariate analysis, there was a trend towards an increased adoption of conservative treatment for HR-/HER2+ (p = 0.01) and Triple Negative tumors (p = 0.06). Implementation of NACT varied significantly among Breast-Centers from 3.8 to 17.7 % (p < 0.001).

Conclusion

The impact of NACT on the subsequent surgical management is substantial and continues to evolve over time, resulting in less-extensive surgery. Even among high-volume Centers NACT implementation rate is still highly variable. Although we registered a significant increase in its use during the study period, these results need to be further improved.

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.