Chen X L, Fan Y, Xu B H
Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2016 Jun 23;38(6):448-53. doi: 10.3760/cma.j.issn.0253-3766.2016.06.009.
To compare the clinicopathological features and prognosis of HER2-negative luminal-type breast cancer patients with early and late recurrence.
We reviewed the records of recurrent breast cancer patients who previously underwent surgery at the Cancer Hospital, Chinese Academy of Medical Sciences between 2003 and 2009. A total of 390 cases were identified as eligible recurrent patients with HER2-negative luminal-type breast cancer. Among them, 279 cases had early recurrence (DFS<5 years) and 111 cases had late recurrence (DFS≥5 years). The clinicopathological features, sites of initial metastasis and survival after recurrence in the two groups were compared and analyzed.
Patients with vascular invasion or and ≥4 lymph node metastases were found more common in the early recurrence group (P<0.05), while positive status of both hormone receptors and non-standardized hormone therapy were more frequently seen in the late recurrence group (P<0.05). In the late recurrence group, initial lung metastasis was seen in 47.7% of patients, significantly higher than that (25.1%) in the early recurrence group (P<0.001). Although initial multiple organ metastases were more common in the late recurrence group (P<0.05), its median overall survival (OS) after recurrence was 66 months, significantly longer than that of the early recurrence group (39 months) (HR=1.6, P=0.003).
The two groups of HER2-negative luminal-type breast cancer patients with early and late recurrence show some differences in clinicopathological features and prognosis. Both vascular invasion and ≥4 lymph node metastases are important factors affecting the DFS in HER-2-negative luminal-type breast cancer patients, and early recurrence is more frequently seen in this group. Late recurrence is the more frequent recurrence pattern in the HER-2 negative luminal type breast cancer patients, especially, in the double hormone receptor-positive patients who received non-standardized hormone therapy. The prognosis for patients with late recurrence is better than that in the patients with early recurrence.
比较HER2阴性管腔型乳腺癌早期复发和晚期复发患者的临床病理特征及预后。
回顾2003年至2009年间在中国医学科学院肿瘤医院接受过手术的复发性乳腺癌患者的病历。共390例患者被确定为符合条件的HER2阴性管腔型复发性乳腺癌患者。其中，279例为早期复发（无病生存期<5年），111例为晚期复发（无病生存期≥5年）。比较并分析两组患者的临床病理特征、初始转移部位及复发后的生存情况。
早期复发组血管侵犯或≥4枚淋巴结转移更为常见（P<0.05），而晚期复发组激素受体阳性状态及非标准化激素治疗更为常见（P<0.05）。晚期复发组中，47.7%的患者初始肺转移，显著高于早期复发组的25.1%（P<0.001）。尽管晚期复发组初始多器官转移更为常见（P<0.05），但其复发后的中位总生存期（OS）为66个月，显著长于早期复发组的39个月（风险比=1.6，P=0.003）。
HER2阴性管腔型乳腺癌早期复发和晚期复发两组患者在临床病理特征及预后方面存在一些差异。血管侵犯和≥4枚淋巴结转移均是影响HER-2阴性管腔型乳腺癌患者无病生存期的重要因素，且该组患者早期复发更为常见。晚期复发是HER-2阴性管腔型乳腺癌患者更常见的复发模式，尤其是在接受非标准化激素治疗的双激素受体阳性患者中。晚期复发患者的预后优于早期复发患者。
