年轻对乳腺癌预后的影响:一项系统综述和荟萃分析。

IF 3.5 4区 医学 Q3 ONCOLOGY
Yongxin Li, Yuanfang Xin, Chengrong Zhang, Jingchuan Qi, Yuyao Tang, Zhoujuan Li, Miaozhou Wang, Zhen Liu, Dengfeng Ren, Zitao Li, Yongzhi Chen, Jinming Li, Hongxia Liang, Yan Zhang, Zhengbo Xu, Jiuda Zhao
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引用次数: 0

摘要

年龄小(≤35岁或≤40岁)对乳腺癌预后的影响尚无共识。本研究对年轻女性乳腺癌的预后进行meta分析。方法:我们检索PubMed、Embase、Web of Science、Cochrane和主要的癌症相关国际会议论文集,从它们成立到2023年6月1日,并于2023年7月15日更新。如果报告的风险比(hr)有95%可信区间(ci)或呈现Kaplan-Meier生存曲线,则纳入研究。主要结局为总生存期(OS)、无病生存期(DFS)、乳腺癌特异性生存期(BCSS)、低局部无复发生存期(LRFS)、远端无病生存期(DDFS)、无进展生存期(PFS)和病理完全缓解(pCR)。该荟萃分析已在PROSPERO注册(CRD42023459282)。结果:荟萃分析,包括129年的研究和大约1065000名患者,捏造年轻乳腺癌(YBC)患者更糟糕的操作系统(HR = 1.30; 95%置信区间:1.17 - 1.43;我²= 93%;P < 0.01), DFS (HR = 1.58; 95%置信区间:1.47 - 1.70;我²= 68%;P < 0.01), bcs (HR = 1.28; 95%置信区间CI: 1·09 - 1.49;我²= 95%;P < 0.01),探测器(HR = 2.05; 95%置信区间:1.59 - 2.59;我²= 70%;P < 0.01),地区指定基金(HR = 1.44; 95%置信区间:1.11 - 1.87;我²= 91%;P < 0.01),和PFS (HR = 1.54; 95%置信区间:1.16 - 2·03;我²= 90%;P < 0.01),且pCR率高于非年轻乳腺癌(NYBC)患者(优势比(OR) = 1.45;95% ci: 1.16 - 1.82;I²= 87%;P < 0.01)。亚组分析显示,与NYBC患者相比,不同分子亚型、不同区域、不同分期的YBC患者预后存在一定差异。讨论:本荟萃分析证实,尽管YBC患者的pCR率更高,但YBC患者的生存结局比NYBC患者更差。亚组分析表明,结果因分子亚型、区域和疾病分期而异。这些发现强调了早期筛查、加强患者教育和针对YBC患者量身定制治疗策略的重要性。结论:YBC患者的OS、DFS、BCSS、LRFS、DDFS、PFS较NYBC患者差,pCR率高于NYBC患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Impact of Young Age on Breast Cancer Prognosis: A Systematic Review and Meta-Analysis.

Introduction: There is no consensus on the impact of young age (≤ 35 or 40) on breast cancer prognosis. In this study, a meta-analysis was carried out on the prognosis of breast cancer in young women.

Methods: We searched PubMed, Embase, Web of Science, Cochrane, and key cancer-related international conference proceedings, from their inception to 1st June, 2023, with an update on 15th July, 2023. Studies were included if they reported hazard ratios (HRs) with 95% confi-dence intervals (CIs) or presented Kaplan-Meier survival curves. The main outcomes were overall survival (OS), disease-free survival (DFS), breast cancer-specific survival (BCSS), lo-cal recurrence-free survival (LRFS), distant disease-free survival (DDFS), progression-free survival (PFS), and pathological complete response (pCR). This meta-analysis was registered in PROSPERO (CRD42023459282).

Results: The meta-analysis, including 129 studies with approximately 1,065,000 patients, re-ported that young breast cancer (YBC) patients had worse OS (HR = 1.30; 95% CI: 1.17 - 1.43; I² = 93%; P < 0.01), DFS (HR = 1.58; 95% CI: 1.47 - 1.70; I² = 68%; P < 0.01), BCSS (HR = 1.28; 95% CI: 1·09 - 1.49; I² = 95%; P < 0.01), LRFS (HR = 2.05; 95% CI: 1.59 - 2.59; I² = 70%; P < 0.01), DDFS (HR = 1.44; 95% CI: 1.11 - 1.87; I² = 91%; P < 0.01), and PFS (HR = 1.54; 95% CI: 1.16 - 2·03; I² = 90%; P < 0.01) and a greater pCR rates than non-young breast cancer (NYBC) patients (odds ratio (OR) = 1.45; 95% CI: 1.16 - 1.82; I² = 87%; P < 0.01). Subgroup analysis demonstrated that, compared with NYBC patients, certain differences were found in the prognoses of YBC patients with different molecular subtypes, regions, and stages.

Discussion: This meta-analysis confirmed that YBC patients have worse survival outcomes than NYBC patients, despite having higher pCR rates. Subgroup analyses demonstrated that outcomes varied by molecular subtype, region, and disease stage. These findings underscore the importance of early screening, enhanced patient education, and tailored treatment strategies for YBC patients.

Conclusion: Patients with YBC had worse OS, DFS, BCSS, LRFS, DDFS, PFS, and greater pCR rates than NYBC patients.

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来源期刊
Current cancer drug targets
Current cancer drug targets 医学-肿瘤学
CiteScore
5.40
自引率
0.00%
发文量
105
审稿时长
1 months
期刊介绍: Current Cancer Drug Targets aims to cover all the latest and outstanding developments on the medicinal chemistry, pharmacology, molecular biology, genomics and biochemistry of contemporary molecular drug targets involved in cancer, e.g. disease specific proteins, receptors, enzymes and genes. Current Cancer Drug Targets publishes original research articles, letters, reviews / mini-reviews, drug clinical trial studies and guest edited thematic issues written by leaders in the field covering a range of current topics on drug targets involved in cancer. As the discovery, identification, characterization and validation of novel human drug targets for anti-cancer drug discovery continues to grow; this journal has become essential reading for all pharmaceutical scientists involved in drug discovery and development.
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