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淋巴结阴性乳腺癌的生物学特征和长期预后

Biological Characteristics and Long-term Outcomes in Node-negative Breast Cancer.

机构信息

Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy.

Biostatistic Unit, Humanitas Clinical and Research Center, Rozzano (Milan), Italy.

出版信息

Clin Breast Cancer. 2020 Aug;20(4):e481-e489. doi: 10.1016/j.clbc.2020.02.011. Epub 2020 Mar 6.

Abstract

BACKGROUND

Because the risk of relapse of node-negative breast cancer (BC) is varying, we evaluated the prognosis of patients with this disease and the factors associated with increased risk of relapse.

PATIENTS AND METHODS

The clinical charts of patients with BC with evidence of negative nodes and with a potential ≥ 5-year follow-up were retrospectively reviewed.

RESULTS

We analyzed 1276 patients. Over a median follow-up of 71.6 months (range, 1-227.2 months), we observed 159 events of relapse or death. The median RFS was 170 months. The median overall survival (OS) was 192 months. At univariate analysis, older age, negative hormonal receptors, larger tumor size and higher proliferation index (Ki67) were associated with worse recurrence-free survival (RFS) and OS (P < .05); higher grading was associated with worse RFS (P = .01). At multivariate analysis for RFS, age, Ki67 and tumor size confirmed their independent prognostic role. At multivariate analysis for OS, age and positive hormonal receptors showed an independent prognostic role. We observed no differences in prognosis between human epidermal growth factor receptor 2 (HER2) positive and triple-negative (TN) BC, but TNBC showed a worse OS compared with luminal-like BC.

CONCLUSIONS

In node-negative BC, age, hormone receptor status, tumor size and Ki67 were prognostic factors. The TNBC subtype was not associated with poorer prognosis compared with the HER2-positive subtype, but showed a worse OS compared with luminal-like BC.

摘要

背景

由于淋巴结阴性乳腺癌(BC)的复发风险存在差异,我们评估了此类患者的预后及与复发风险增加相关的因素。

患者与方法

我们回顾性分析了经组织学证实为淋巴结阴性且有潜在≥5 年随访的 BC 患者的临床资料。

结果

共分析了 1276 例患者。中位随访时间为 71.6 个月(范围,1-227.2 个月),观察到 159 例复发或死亡事件。中位无复发生存期(RFS)为 170 个月。中位总生存期(OS)为 192 个月。单因素分析显示,年龄较大、激素受体阴性、肿瘤较大和较高的增殖指数(Ki67)与较差的 RFS 和 OS 相关(P<0.05);高分级与较差的 RFS 相关(P=0.01)。多因素分析显示,年龄、Ki67 和肿瘤大小与 RFS 的独立预后作用相关。多因素分析显示,年龄和激素受体阳性与 OS 的独立预后作用相关。我们发现 HER2 阳性和三阴性(TN)BC 之间的预后无差异,但 TNBC 与 luminal-like BC 相比 OS 更差。

结论

在淋巴结阴性 BC 中,年龄、激素受体状态、肿瘤大小和 Ki67 是预后因素。与 HER2 阳性亚型相比,TNBC 亚型的预后并不差,但与 luminal-like BC 相比 OS 更差。

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