Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Oncologist. 2011;16(12):1675-83. doi: 10.1634/theoncologist.2011-0196. Epub 2011 Dec 6.
Numerous studies have demonstrated that expression of estrogen/progesterone receptor (ER/PR) and human epidermal growth factor receptor (HER)-2 is important for predicting overall survival (OS), distant relapse (DR), and locoregional relapse (LRR) in early and advanced breast cancer patients. However, these findings have not been confirmed for inflammatory breast cancer (IBC), which has different biological features than non-IBC.
We retrospectively analyzed the records of 316 women who presented to MD Anderson Cancer Center in 1989-2008 with newly diagnosed IBC without distant metastases. Most patients received neoadjuvant chemotherapy, mastectomy, and postmastectomy radiation. Patients were grouped according to receptor status: ER(+) (ER(+)/PR(+) and HER-2-; n = 105), ER(+)HER-2(+) (ER(+)/PR(+) and HER-2(+); n = 37), HER-2(+) (ER(-)/PR(-) and HER-2(+); n = 83), or triple-negative (TN) (ER(-)PR(-)HER-2(-); n = 91). Kaplan-Meier and Cox proportional hazards methods were used to assess LRR, DR, and OS rates and their associations with prognostic factors.
The median age was 50 years (range, 24-83 years). The median follow-up time and median OS time for all patients were both 33 months. The 5-year actuarial OS rates were 58.7% for the entire cohort, 69.7% for ER(+) patients, 73.5% for ER(+)HER-2(+) patients, 54.0% for HER=2(+) patients, and 42.7% for TN patients (p < .0001); 5-year LRR rates were 20.3%, 8.0%, 12.6%, 22.6%, and 38.6%, respectively, for the four subgroups (p < .0001); and 5-year DR rates were 45.5%, 28.8%, 50.1%, 52.1%, and 56.7%, respectively (p < .001). OS and LRR rates were worse for TN patients than for any other subgroup (p < .0001-.03).
TN disease is associated with worse OS, DR, and LRR outcomes in IBC patients, indicating the need for developing new locoregional and systemic treatment strategies for patients with this aggressive subtype.
大量研究表明，雌激素/孕激素受体（ER/PR）和人表皮生长因子受体（HER-2）的表达对于预测早期和晚期乳腺癌患者的总生存（OS）、远处复发（DR）和局部区域复发（LRR）至关重要。然而，这些发现并未得到炎性乳腺癌（IBC）的证实，IBC 具有与非 IBC 不同的生物学特征。
我们回顾性分析了 1989 年至 2008 年期间在 MD 安德森癌症中心就诊的 316 名新诊断为无远处转移的 IBC 女性患者的病历。大多数患者接受了新辅助化疗、乳房切除术和乳房切除术后放疗。根据受体状态将患者分为以下几组：ER(+)（ER(+)/PR(+) 和 HER-2-；n=105）、ER(+)HER-2(+)（ER(+)/PR(+) 和 HER-2(+)；n=37）、HER-2(+)（ER(-)/PR(-) 和 HER-2(+)；n=83）或三阴性（TN）（ER(-)PR(-)HER-2(-)；n=91）。采用 Kaplan-Meier 和 Cox 比例风险方法评估 LRR、DR 和 OS 率及其与预后因素的关系。
中位年龄为 50 岁（范围 24-83 岁）。所有患者的中位随访时间和中位 OS 时间均为 33 个月。整个队列的 5 年生存率为 58.7%，ER(+)患者为 69.7%，ER(+)HER-2(+)患者为 73.5%，HER-2(+)患者为 54.0%，TN 患者为 42.7%（p<0.0001）；四个亚组的 5 年 LRR 率分别为 20.3%、8.0%、12.6%、22.6%和 38.6%（p<0.0001）；5 年 DR 率分别为 45.5%、28.8%、50.1%、52.1%和 56.7%（p<0.001）。与其他任何亚组相比，TN 患者的 OS 和 LRR 更差（p<0.0001-.03）。
TN 疾病与 IBC 患者的 OS、DR 和 LRR 结局较差相关，表明需要为这种侵袭性亚型患者制定新的局部区域和全身治疗策略。
