Hennigs André, Riedel Fabian, Gondos Adam, Sinn Peter, Schirmacher Peter, Marmé Frederik, Jäger Dirk, Kauczor Hans-Ulrich, Stieber Anne, Lindel Katja, Debus Jürgen, Golatta Michael, Schütz Florian, Sohn Christof, Heil Jörg, Schneeweiss Andreas
Department of Gynecology and Obstetrics, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
BMC Cancer. 2016 Sep 15;16(1):734. doi: 10.1186/s12885-016-2766-3.
In Germany, most breast cancer patients are treated in specialized breast cancer units (BCU), which are certified, and routinely monitored. Herein, we evaluate up-to-date oncological outcome of breast cancer (BC) molecular subtypes in routine clinical care of a specialized BCU.
The study was a prospectively single-center cohort study of 4102 female cases with primary, unilateral, non-metastatic breast cancer treated between 01 January 2003 and 31 December 2012. The five routinely used molecular subtypes (Luminal A-like, Luminal B/HER2 negative-like, Luminal B/HER2 positive-like, HER2-type, Triple negative) were analyzed. The median follow-up time of the whole cohort was 55 months. We calculated estimates for local control rate (LCR), disease-free survival (DFS), distant disease-free survival (DDFS), overall survival (OS), and relative overall survival (ROS).
Luminal A-like tumors were the most frequent (44.7 %) and showed the best outcome with LCR of 99.1 % (95 % CI 98.5; 99.7), OS of 95.1 % (95 % CI 93.7; 96.5), and ROS of 100.0 % (95 % CI 98.5; 101.5). Triple negative tumors (12.3 %) presented the poorest outcome with LCR of 89.6 % (95 % CI 85.8; 93.4), OS of 78.5 % (95 % CI 73.8; 83.3), and ROS of 80.1 % (95 % CI 73.8; 83.2).
Patients with a favorable subtype can expect an OS above 95 % and an LCR of almost 100 % over 5 years. On the other hand the outcome of patients with HER2 and Triple negative subtypes remains poor, thus necessitating more intensified research and care.
在德国，大多数乳腺癌患者在经过认证且定期监测的专业乳腺癌治疗单元（BCU）接受治疗。在此，我们评估了专业BCU常规临床护理中乳腺癌（BC）分子亚型的最新肿瘤学结局。
该研究是一项前瞻性单中心队列研究，纳入了2003年1月1日至2012年12月31日期间接受治疗的4102例原发性、单侧、非转移性乳腺癌女性病例。分析了五种常规使用的分子亚型（Luminal A样、Luminal B/HER2阴性样、Luminal B/HER2阳性样、HER2型、三阴性）。整个队列的中位随访时间为55个月。我们计算了局部控制率（LCR）、无病生存率（DFS）、远处无病生存率（DDFS）、总生存率（OS）和相对总生存率（ROS）的估计值。
Luminal A样肿瘤最为常见（44.7%），其结局最佳，LCR为99.1%（95%CI 98.5；99.7），OS为95.1%（95%CI 93.7；96.5），ROS为100.0%（95%CI 98.5；101.5）。三阴性肿瘤（12.3%）的结局最差，LCR为89.6%（95%CI 85.8；93.4），OS为78.5%（95%CI 73.8；83.3），ROS为80.1%（95%CI 73.8；83.2）。
具有良好亚型的患者在5年内的OS有望超过95%且LCR接近100%。另一方面，HER2和三阴性亚型患者的结局仍然较差，因此需要加强研究和护理。
