通过新辅助化疗获得病理完全反应的不同分子亚型乳腺浸润性导管癌的临床病理特征和生存率分析

IF 2.5 3区医学 Q3 ONCOLOGY

World Journal of Surgical Oncology Pub Date : 2024-09-16 DOI:10.1186/s12957-024-03535-x

Cheng Xiao, Yao Guo, Yang Xu, Junhua Huang, Junyan Li

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引用次数: 0

摘要

研究不同分子亚型的乳腺浸润性导管癌患者通过新辅助化疗获得病理完全反应（pCR）后的预后差异。从监测、流行病学和最终结果（SEER）中找出了2010年至2019年期间接受新辅助化疗并获得病理完全反应的乳腺浸润性导管癌患者的数据，比较了不同分子亚型患者的临床病理特征。利用单变量和Cox多变量分析确定总生存期（OS）和癌症特异性生存期（CSS）的独立预测因素。Kaplan-Meier方法用于比较不同分子亚型的OS和CSS。经过倾向评分匹配后，亚组分析结果通过森林图呈现。该研究纳入了9380名确诊为浸润性导管癌的患者，并将其分为四种分子亚型：2721人（29.01%）为HR + /HER-2 +亚型，1661人（17.71%）为HR + /HER2-亚型，2082人（22.20%）为HR-/HER2 +亚型，2916人（31.08%）为HR-/HER-2-亚型。HR + /HER-2-亚组中 50 岁以下患者的比例明显高于其他亚组（54.67% vs 40.2%、50.35% 和 51.82%，P < 0.01），且 N2 + N3 分期更高（11.2% vs 7.24%、8.69% 和 7.48%，P < 0.01）。单变量和多变量分析显示，分子亚型是影响患者OS和CSS的独立危险因素（P < 0.05）。Kaplan-Meier曲线显示，HR + /HER-2 +亚型的OS和CSS最高（P < 0.05）。其次是HR-/HER-2 +和HR-/HER-2-亚型，其中HR + /HER-2-组的OS和CSS最低（P < 0.05）。经过倾向得分匹配后，HR + /HER-2 +组患者的OS和CSS仍高于HR + /HER-2-组（P < 0.05）。不同分子亚型的浸润性导管癌患者在接受新辅助化疗达到pCR后，会表现出不同的预后。HR + /HER-2-组患者更年轻、淋巴结分期更高、OS和CSS最低，而HR + /HER-2+组患者的OS和CSS最高。

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Clinicopathological characteristics and survival analysis of different molecular subtypes of breast invasive ductal carcinoma achieving pathological complete response through neoadjuvant chemotherapy

To investigate the prognostic differences following the achievement of a pathological complete response (pCR) through neoadjuvant chemotherapy across different molecular subtypes of breast invasive ductal carcinoma. Data from the Surveillance, Epidemiology, and End Results (SEER) were identified for patients undergoing neoadjuvant chemotherapy who achieved pathological complete response for invasive ductal carcinoma of the breast between 2010 and 2019.Comparing the clinicopathological characteristics of patients across different molecular subtypes. Univariate and Cox multivariate analyses were utilized to identify independent predictors of overall survival (OS) and cancer-specific survival (CSS). The Kaplan–Meier method is used to compare OS and CSS among different molecular subtypes. After propensity score matching, subgroup analysis results were presented through forest plots. This study included 9,380 patients diagnosed with invasive ductal carcinoma, who were categorized into four molecular subtypes: 2,721 (29.01%) HR + /HER-2 + , 1,661 (17.71%) HR + /HER2-, 2,082 (22.20%) HR-/HER2 + , and 2,916 (31.08%) HR-/HER-2-. HR + /HER-2- subgroup exhibited a significantly higher proportion of patients under 50 years old than the other subtype groups (54.67% vs 40.2%, 50.35% and 51.82%, p < 0.01), and had a higher N2 + N3 stage (11.2% vs 7.24%, 8.69% and 7.48%, p < 0.01). Univariate and multivariate analysis revealed that molecular subtype was the independent risk factor for OS and CSS in patients(p < 0.05). The Kaplan–Meier curves indicated that the HR + /HER-2 + subtype had the highest OS and CSS(p < 0.05). Next, were the HR-/HER-2 + and HR-/HER-2- subtypes, with the HR + /HER-2- group having the lowest OS and CSS(p < 0.05). After propensity score matching, the OS and CSS of patients in the HR + /HER-2 + group remained higher compared to HR + /HER-2- group(p < 0.05). Patients with invasive ductal carcinoma of different molecular subtypes exhibit varying prognoses after achieving pCR to neoadjuvant chemotherapy. Those in the HR + /HER-2- group are younger, have a higher lymph node stage, and the lowest OS and CSS, whereas patients in the HR + /HER-2 + group have the highest OS and CSS.

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来源期刊

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.