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保乳治疗的三阴性乳腺癌(TNBC)与非三阴性乳腺癌患者的肿瘤学结局比较

Comparisons of Oncologic Outcomes between Triple-Negative Breast Cancer (TNBC) and Non-TNBC among Patients Treated with Breast-Conserving Therapy.

作者信息

Kim Sanghwa, Park Hyung Seok, Kim Jee Ye, Ryu Jegyu, Park Seho, Kim Seung Il

机构信息

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Yonsei Med J. 2016 Sep;57(5):1192-8. doi: 10.3349/ymj.2016.57.5.1192.

Abstract

PURPOSE

The optimum local surgical strategy regarding breast-conserving therapy (BCT) for triple-negative breast cancer (TNBC) is controversial. To investigate whether BCT is appropriate for patients with TNBC, we evaluated the clinical outcomes of BCT in women with TNBC compared to those of women without TNBC, using a large, single-center cohort.

MATERIALS AND METHODS

We performed a retrospective analysis of 1533 women (TNBC n=321; non-TNBC n=1212) who underwent BCT for primary breast cancer between 2000 and 2010. Clinicopathological characteristics, locoregional recurrence-free survival (LRFS), and overall survival (OS) were analyzed.

RESULTS

Tumors from the TNBC group had a higher T stage (T2 37.4% vs. 21.0%, p<0.001), a lower N stage (N0 86.9% vs. 75.5%, p<0.001), and a higher histologic grade (Grade III 66.8% vs. 15.4%, p<0.001) than the non-TNBC group. There were no differences in 5-year LRFS rates between the TNBC and non-TNBC groups (98.7% vs. 97.8%, p=0.63). The non-TNBC group showed a slightly better 5-year OS than the TNBC group; however, the difference was not significant (96.2% vs. 97.3%, p=0.72). In multivariate analyses, TNBC was not associated with poor clinical outcomes in terms of LRFS and OS [hazard ratio (HR) for LRFS=0.37, 95% confidence interval (CI): 0.10-1.31; HR for OS=1.03, 95% CI: 0.31-3.39].

CONCLUSION

TNBC patients who underwent BCT showed non-inferior locoregional recurrence compared to non-TNBC patients with BCT. Thus, BCT is an acceptable surgical approach in patients with TNBC.

摘要

目的

关于三阴性乳腺癌(TNBC)保乳治疗(BCT)的最佳局部手术策略存在争议。为了研究BCT是否适用于TNBC患者,我们使用一个大型单中心队列,评估了TNBC女性患者与非TNBC女性患者BCT的临床结局。

材料与方法

我们对2000年至2010年间因原发性乳腺癌接受BCT的1533名女性进行了回顾性分析(TNBC组n = 321;非TNBC组n = 1212)。分析了临床病理特征、局部区域无复发生存期(LRFS)和总生存期(OS)。

结果

与非TNBC组相比,TNBC组的肿瘤T分期更高(T2期37.4%对21.0%,p<0.001),N分期更低(N0期86.9%对75.5%,p<0.001),组织学分级更高(III级66.8%对15.4%,p<0.001)。TNBC组和非TNBC组的5年LRFS率无差异(98.7%对97.8%,p = 0.63)。非TNBC组的5年OS略优于TNBC组;然而,差异不显著(96.2%对97.3%,p = 0.72)。在多变量分析中,就LRFS和OS而言,TNBC与不良临床结局无关[LRFS的风险比(HR)= 0.37,95%置信区间(CI):0.10 - 1.31;OS的HR = 1.03,95% CI:0.31 - 3.39]。

结论

接受BCT的TNBC患者与接受BCT的非TNBC患者相比,局部区域复发情况不差。因此,BCT是TNBC患者可接受的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1395/4960386/022c6dd3ebdc/ymj-57-1192-g001.jpg

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