Li Shuang, Ma Ding, Shi Hao-Hong, Yu Ke-Da, Zhang Qiang
Department of Breast Surgery, Liaoning Cancer Hospital and Institute, Shenyang 110042, China.
Department of Breast Surgery, Shanghai Cancer Center and Cancer Institute, Children's Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China.
J Thorac Dis. 2018 May;10(5):2837-2841. doi: 10.21037/jtd.2018.04.94.
For triple negative breast cancer (TNBC), the optimal time from surgery to initiation of adjuvant chemotherapy is controversial. We investigated the influence of time to adjuvant chemotherapy on outcome in TNBC patients.
Female patients with stage I-IIIa operable TNBC between 2006 and 2008 in our institutions were included. A total of 331 patients were divided into 3 groups according to the time to adjuvant chemotherapy: ≤30, 31-60, and >60 days. Relapse free survival (RFS) were calculated and compared.
Prolonged delay of initiation of adjuvant chemotherapy (≤30 versus >60 days) significantly decreased the RFS in our TNBC cohort [adjusted hazard ratio (HR) of 2.39; 95% confidence interval (CI), 1.13-5.07, P=0.02]. While a moderate delay (≤30 versus 31-60 days) did not significantly influence RFS in all TNBC patients, it did compromise survival in lymph node positive patients (P=0.04).
Longer delay of adjuvant chemotherapy was associated with worse survival in TNBC patients. Early initiation of adjuvant chemotherapy should be considered, especially for relatively high risk node positive TNBCs.
对于三阴性乳腺癌（TNBC），从手术到开始辅助化疗的最佳时间存在争议。我们研究了辅助化疗时间对TNBC患者预后的影响。
纳入2006年至2008年在我们机构就诊的I-IIIa期可手术TNBC女性患者。根据辅助化疗时间将331例患者分为3组：≤30天、31-60天和>60天。计算并比较无复发生存期（RFS）。
在我们的TNBC队列中，辅助化疗开始时间的延长（≤30天与>60天相比）显著降低了RFS[调整后的风险比（HR）为2.39；95%置信区间（CI），1.13-5.07，P=0.02]。虽然中度延迟（≤30天与31-60天相比）在所有TNBC患者中对RFS没有显著影响，但在淋巴结阳性患者中确实影响了生存（P=0.04）。
辅助化疗延迟时间越长，TNBC患者的生存越差。应考虑尽早开始辅助化疗，尤其是对于风险相对较高的淋巴结阳性TNBC患者。
