Yamamura Jun, Kamigaki Shunji, Tsujie Masaki, Fujita Junya, Osato Hiroki, Higashi Chihiro, Kanaizumi Hirofumi, Tanaka Yumiko, Hamada Mika, Shinzaki Wataru, Hashimoto Yukihiko, Komoike Yoshifumi
Department of Surgery, Sakai City Medical Center, Osaka, Japan
Division of Breast and Endocrine Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan.
In Vivo. 2019 Jan-Feb;33(1):281-287. doi: 10.21873/invivo.11473.
BACKGROUND/AIM: Little evidence is currently available on significant determinants of post-recurrence survival for patients with hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer. The objective of this study was to evaluate factors influencing post-recurrence survival in HR+/HER2-breast cancer.
A cohort of 236 patients with recurrent HR+/HER2- breast cancer was retrospectively analyzed to identify significant factors correlating with prognosis after recurrence.
Multivariate analysis revealed independent prognostic factors of poor survival as follows: short intervals between recurrence and the end of adjuvant endocrine therapy (ET; p=0.046); short disease-free intervals (p=0.019); liver metastasis (p=0.007) or multiple metastases (p<0.001) at recurrence; and a poor response to first-line treatment (p<0.001). A poor first-line treatment response was significantly associated with a shorter response to a subsequent treatment line (p=0.007). Logistic regression analysis indicated that liver metastasis significantly increased the risk of a poor first-line-ET response (p=0.009).
The first-line treatment response was the key to post-recurrence survival in patients with HR+/HER2- breast cancer. Particularly poor responses led to subsequent unfavorable prognostic outcomes.
背景/目的:目前关于激素受体阳性(HR+)、人表皮生长因子受体2阴性(HER2-)乳腺癌患者复发后生存的重要决定因素的证据较少。本研究的目的是评估影响HR+/HER2-乳腺癌复发后生存的因素。
回顾性分析236例复发性HR+/HER2-乳腺癌患者,以确定与复发后预后相关的重要因素。
多因素分析显示生存不良的独立预后因素如下:复发与辅助内分泌治疗(ET)结束之间的间隔时间短(p=0.046);无病间期短(p=0.019);复发时肝转移(p=0.007)或多发转移(p<0.001);以及对一线治疗反应差(p<0.001)。一线治疗反应差与后续治疗线的反应时间短显著相关(p=0.007)。逻辑回归分析表明,肝转移显著增加一线ET反应差的风险(p=0.009)。
一线治疗反应是HR+/HER2-乳腺癌患者复发后生存的关键。特别差的反应会导致随后不良的预后结果。