Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Clin Breast Cancer. 2018 Dec;18(6):e1353-e1360. doi: 10.1016/j.clbc.2018.07.014. Epub 2018 Jul 24.
Patients with hormone receptor-positive and human epidermal growth factor receptor 2-negative (HR/HER2) breast cancer have a constant risk of relapse over time. Nearly one-half of the recurrences occur more than 5 years after diagnosis, described as late recurrence, but little is known about late recurrence.
We reviewed the clinical data of 1941 patients with HR/HER2 breast cancer who had operations in the Cancer Institute and Hospital, Chinese Academy of Medical Sciences, during 2003 to 2009, and found 390 relapsed cases. Among them, 281 patients were early recurrence, and 109 were late recurrence.
In the late recurrence group, patients with ≤ 3 lymph node metastases, double HR (estrogen receptor-positive/progesterone receptor-positive) were more common (72.48% vs. 55.52%; P = .005; 82.57% vs. 71.89%; P = .029, respectively) when compared with the early recurrence group. The lung seemed to be a preferential site of late recurrence. Although visceral disease and multi-organ metastases were more frequent in the late recurrence group, survival after recurrence was significantly longer than that in the early recurrence group (52 vs. 40 months; hazard ratio, 1.508; 95% confidence interval, 1.142-1.992; P = .003). Moreover, progression-free survival of first-line treatment was an independent prognostic factor of survival after recurrence in the late recurrence group.
Late recurrence differed from early recurrence in many ways in HR/HER2 breast cancer, and its prognosis was much better. The lung may be a preferential site of late recurrence. More attention should be paid to late recurrence itself.
激素受体阳性和人表皮生长因子受体 2 阴性（HR/HER2）的乳腺癌患者随着时间的推移复发风险持续存在。近一半的复发发生在诊断后 5 年以上，称为晚期复发，但对晚期复发知之甚少。
我们回顾了 2003 年至 2009 年期间在中国医学科学院肿瘤医院接受手术的 1941 例 HR/HER2 乳腺癌患者的临床资料，发现 390 例复发病例。其中，281 例为早期复发，109 例为晚期复发。
在晚期复发组中，与早期复发组相比，淋巴结转移≤3 枚、双 HR（雌激素受体阳性/孕激素受体阳性）的患者更为常见（72.48% vs. 55.52%；P=0.005；82.57% vs. 71.89%；P=0.029）。晚期复发似乎更倾向于肺。尽管晚期复发组中内脏疾病和多器官转移更为常见，但复发后的生存时间明显长于早期复发组（52 个月 vs. 40 个月；风险比，1.508；95%置信区间，1.142-1.992；P=0.003）。此外，一线治疗的无进展生存是晚期复发组复发后生存的独立预后因素。
HR/HER2 乳腺癌的晚期复发与早期复发在许多方面存在差异，其预后要好得多。肺可能是晚期复发的首选部位。应更加关注晚期复发本身。
