美国癌症联合委员会(AJCC)第8版分期系统在HER2富集亚型乳腺癌中的预后价值:一项回顾性分析
The Prognostic Value of the 8th Edition of the American Joint Committee on Cancer (AJCC) Staging System in HER2-Enriched Subtype Breast Cancer, a Retrospective Analysis.
作者信息
Zhou Bin, Xu Ling, Ye Jingming, Xin Ling, Duan Xuening, Liu Yinhua
机构信息
Breast Disease Center, Peking University First Hospital, Beijing, P.R. China.
Cardiff China Medical Research Collaborative, Cardiff University School of Medicine, Cardiff, U.K.
出版信息
Anticancer Res. 2017 Aug;37(8):4615-4621. doi: 10.21873/anticanres.11862.
BACKGROUND/AIM: The American Joint Committee on Cancer (AJCC) released its 8th edition of tumor staging which is to be implemented in early 2018. The present study aimed to analyze the prognostic value of AJCC 8th edition Cancer Staging System in HER2-enriched breast cancer, on a retrospective cohort.
PATIENTS AND METHODS
This study was a retrospective single-center study of HER2-enriched breast cancer cases diagnosed from January 2008 to December 2014. Clinicopathological features and follow up data including disease-free survival (DFS) and overall survival (OS) were analyzed to explore prognostic factors for disease outcome. We restaged patients based on the 8th edition of the AJCC cancer staging system and analyzed prognostic value of the Anatomic Stage Group and the Prognostic Stage Group.
RESULTS
The study enrolled 170 HER2-enriched subtype breast cancer patients with 5-year disease free survival (DFS) of 85.1% and 5-year overall survival (OS) of 86.8%. Prognostic stages of 117 cases (68.8%) changed compared with anatomic stages, with 116 upstaged cases and 1 downstaged case. The Anatomic Stage Groups had a significant prognostic impact on DFS (χ=16.752, p<0.001) and OS (χ=25.038, p<0.001). The Prognostic Staging Groups had a significant prognostic impact on DFS (χ=6.577, p=0.037) and OS (χ=21.762, p<0.001). In the multivariate analysis, both stage groups were independent predictors of OS.
CONCLUSION
Both Anatomic and Prognostic Stage Groups in the 8th edition of the AJCC breast cancer staging system had prognostic value in HER2-enriched subtype breast cancer. The Prognostic Stage system was a breakthrough on the basis of anatomic staging system.
背景/目的:美国癌症联合委员会(AJCC)发布了第8版肿瘤分期,将于2018年初实施。本研究旨在对HER2富集型乳腺癌的回顾性队列分析AJCC第8版癌症分期系统的预后价值。
患者与方法
本研究是一项对2008年1月至2014年12月诊断的HER2富集型乳腺癌病例的回顾性单中心研究。分析临床病理特征及包括无病生存期(DFS)和总生存期(OS)在内的随访数据,以探索疾病转归的预后因素。我们根据AJCC癌症分期系统第8版对患者进行重新分期,并分析解剖学分期组和预后分期组的预后价值。
结果
本研究纳入170例HER2富集亚型乳腺癌患者,5年无病生存期(DFS)为85.1%,5年总生存期(OS)为86.8%。117例(68.8%)患者的预后分期与解剖学分期相比发生了变化,其中116例分期上调,1例分期下调。解剖学分期组对DFS(χ=16.752,p<0.001)和OS(χ=25.038,p<0.001)有显著的预后影响。预后分期组对DFS(χ=6.577,p=0.037)和OS(χ=21.762,p<0.001)有显著的预后影响。在多因素分析中,两个分期组均为OS的独立预测因素。
结论
AJCC乳腺癌分期系统第8版的解剖学分期组和预后分期组在HER2富集亚型乳腺癌中均具有预后价值。预后分期系统是在解剖学分期系统基础上的一个突破。