基于肿瘤亚型的早期乳腺癌患者新辅助化疗与辅助化疗后的局部复发：一项多机构回顾性队列研究。

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2024-10-29 DOI:10.1016/j.breast.2024.103828

Jong-Ho Cheun , Youngji Kwak , Eunhye Kang , Ji-Jung Jung , Hong-Kyu Kim , Han-Byoel Lee , Kyung-Hun Lee , Hyeong-Gon Moon , Ki-Tae Hwang , Yeon Hee Park , Jeong Eon Lee , Wonshik Han

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引用次数: 0

摘要

背景：早期乳腺癌新辅助化疗（NACT）与局部复发（LRR）风险增加有关。我们研究了新辅助化疗后局部复发的风险在不同肿瘤亚型中是否存在差异：我们回顾性审查了 2004 年 1 月 1 日至 2018 年 12 月 31 日期间在三家机构接受乳腺癌保乳手术的女性的病历。患者接受了NACT或辅助化疗（ACT），随后接受了放疗。根据激素受体（HR）和人表皮生长因子受体-2（HER2）状态，采用倾向评分匹配、对数秩检验和Cox回归分析法对LRR进行了分析：在10328名患者中，有2479人（24.0%）接受了NACT治疗。在中位随访 84.5 个月（IQR，35.1-118.5）期间，ACT 组和 NACT 组的 10 年无 LRR 生存率分别为 94.5% 和 90.7%（危险比：2.04，95% 置信区间 [CI]：1.68-2.46，P<0.05）：结论：HR+/HER2-亚型患者在接受NACT治疗后发生LRR的风险增加，而其他亚型患者的无LRR生存率相当。

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Locoregional recurrence after neoadjuvant versus adjuvant chemotherapy based on tumor subtypes in patients with early-stage breast cancer: A multi-institutional retrospective cohort study

Background

Neoadjuvant chemotherapy (NACT) for early-stage breast cancer is associated with an increased risk of locoregional recurrence (LRR). We investigated whether the risk of LRR after NACT varies across tumor subtypes.

Methods

We retrospectively reviewed the medical records of women who underwent breast-conserving surgery for breast cancer at three institutions between January 1, 2004, and December 31, 2018. Patients received either NACT or adjuvant chemotherapy (ACT), followed by radiotherapy. LRR was analyzed according to the hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) status using propensity score matching, log-rank test, and Cox regression analysis.

Results

Among 10,328 patients, 2479 (24.0 %) received NACT. Within the median follow-up of 84.5 (IQR, 35.1–118.5) months, the 10-year LRR-free survival rates were 94.5 % and 90.7 % for the ACT and NACT groups, respectively (hazard ratio: 2.04, 95 % confidence interval [CI]: 1.68–2.46, p < 0.0001). NACT was significantly associated with higher LRR in the HR+/HER2− (hazard ratio: 2.52, 95 % CI: 1.83–3.46, p < 0.0001) and HR−/HER2− (hazard ratio: 1.85, 95 % CI: 1.37–2.50, p < 0.0001) subtypes. In the HR+/HER2− subtype, the elevated risk remained significant after propensity-score matching and Cox-regression analysis. However, NACT was not associated with LRR in the HR−/HER2− subtype after adjusting for other variables. Annual LRR pattern among the HR+/HER2− subtype showed the highest incidence in the early period of treatment.

Conclusion

Patients with the HR+/HER2− subtype showed an increased risk of LRR after NACT, while those with other subtypes showed comparable LRR-free survival.

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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.