治疗间隔对年轻乳腺癌患者预后的影响：来自法国国家队列的启示。

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-11-12 DOI:10.1016/j.ejso.2024.109373

Enora Laas , Elise Dumas , Anne-Sophie Hamy , Thomas Gaillard , Paul Gougis , Fabien Reyal , François Husson , Anne-Sophie Jannot

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引用次数: 0

摘要

背景：众所周知，不恰当的治疗延迟会影响癌症患者的预后，但对特定亚群体的最佳治疗时机的研究仍然很少。本研究旨在利用法国全国数据分析年轻女性乳腺癌（BC）治疗延迟及其对预后的影响：我们利用基于法国国家医疗系统数据库的CAREPAT-YBC队列，分析了22093名年轻女性（18-45岁）的无病生存率（DFS），这些女性接受了手术-化疗-放疗路径（辅助治疗，15433名患者）或化疗-手术-放疗路径（新辅助治疗，6660名患者），并根据不同路径之间的延迟情况进行了分析：结果：对于辅助化疗-放疗间隔，最佳时间为17-31天，超过这一延迟时间，风险会增加。对于新辅助治疗，最佳的新辅助化疗-手术间隔为17-31天，而≤15天（HR 1.44，95%CI 1.21-1.71）或≥62天（HR 2.07，95%CI 1.36-3.15）则预后较差。将最佳治疗时间合并为 "最佳治疗路径 "可使复发或死亡风险分别降低1.2倍：结论：优化治疗间隔可提高年轻乳腺癌患者的生存率。

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The influence of treatment intervals on prognosis in young breast cancer patients: Insights from the French National cohort

Background

Suboptimal treatment delays is known to impact prognosis of patients with cancer but optimal timing in specific subgroups remains poorly studied. This study aimed to analyze treatment delays in young women treated for a breast cancer (BC) on and its impact on their prognosis using French Nationwide Data.

Methods

Using the CAREPAT-YBC Cohort based on the French National Healthcare System Database, we analyzed disease-free survival (DFS) in 22,093 young women (18–45 years) who underwent either surgery-chemotherapy-radiotherapy pathway (adjuvant setting, 15,433 patients) or chemotherapy-surgery-radiotherapy pathway (neoadjuvant setting, 6660 patients), according to delays between the different pathways.

Results

For the adjuvant chemotherapy-radiotherapy interval, the best timing was 17–31 days with increased risk above this delay. For the neoadjuvant setting, the optimal neoadjuvant chemotherapy-surgery interval was 17–31 days, while ≤15 days (HR 1.44, 95%CI 1.21–1.71) or ≥62 days (HR 2.07, 95%CI 1.36–3.15) showed poorer prognosis. Combining best timing into an "optimal pathway" was associated with respectively a 1.2-fold decreased risk for recurrence or mortality.

Conclusion

Optimizing treatment intervals enhance BC survival in younger age.

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.