Department of Surgery, Institut Curie, Paris, France.
Residual Tumour & Response to Treatment Laboratory, RT2Lab, PSL Research University, Translational Research Department, Institut Curie, Paris, France.
PLoS One. 2019 Jan 23;14(1):e0208807. doi: 10.1371/journal.pone.0208807. eCollection 2019.
We studied the relationship between time to ipsilateral breast tumor recurrence (IBTR) and distant metastasis-free survival (DMFS) in patients with breast cancer treated by neoadjuvant chemotherapy (NAC).
Between 2002 and 2012, 1199 patients with primary breast cancer were treated with NAC. Clinical, radiological and pathological data were retrieved from medical records. Multivariate analysis was performed with the random survival forest (RSF) method, to evaluate the relationship between time to local recurrence and DMFS.
Time to IBTR, local recurrence and molecular subtype were the factors most strongly associated with DMFS. In the total population, DMFS increased linearly with recurrence time, up to 50 months. For recurrences after 50 months, DMFS was similar for all times to recurrence. Considering molecular subtypes separately, the threshold was similar for the TNBC subtype (50 months), but appeared to occur later for the luminal and HER2-positive subtypes (75 months).
A threshold of 50 months seems to differentiate between early and late recurrences and could be used to guide the medical management of local breast tumour recurrences.
我们研究了接受新辅助化疗（NAC）治疗的乳腺癌患者同侧乳房肿瘤复发（IBTR）和远处无病生存（DMFS）之间的关系。
2002 年至 2012 年间，1199 例原发性乳腺癌患者接受了 NAC 治疗。从病历中检索了临床、影像学和病理学数据。采用随机生存森林（RSF）方法进行多变量分析，以评估局部复发时间与 DMFS 之间的关系。
IBTR 时间、局部复发和分子亚型是与 DMFS 最密切相关的因素。在总人群中，DMFS 随复发时间呈线性增加，最长可达 50 个月。对于 50 个月后的复发，所有复发时间的 DMFS 相似。分别考虑分子亚型时，三阴性乳腺癌（TNBC）亚组的阈值为 50 个月，但在 luminal 和 HER2 阳性亚组中似乎较晚（75 个月）。
50 个月的阈值似乎可以区分早期和晚期复发，并可用于指导局部乳房肿瘤复发的医学管理。
