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他莫昔芬对男性乳腺癌的生存获益:前瞻性队列分析。

Survival benefit of tamoxifen in male breast cancer: prospective cohort analysis.

机构信息

Department of Gynaecology and Obstetrics, Otto-von-Guericke University, Magdeburg, Germany.

Department of Gynecology and Obstetrics, Klinikum Magdeburg, Magdeburg, Germany.

出版信息

Br J Cancer. 2020 Jul;123(1):33-37. doi: 10.1038/s41416-020-0857-z. Epub 2020 May 5.

Abstract

BACKGROUND

Due to the lack of prospective data, current treatment of male breast cancer (MBC) is based on information obtained from retrospective analysis or by extrapolation from studies on female patients. In this prospectively enrolled cohort study, we retrospectively examined the survival effect of tamoxifen in MBC patients.

METHODS

In this prospectively enrolled cohort study, 448 patients with MBC were treated between May 2009 and June 2018. The primary endpoint was disease-free survival (DFS).

RESULTS

Between May 2009 and June 2018, 448 men with breast cancer were identified, with a median age at diagnosis of 69 years (range 27-96 years). The median follow-up was 39 months (range 3-89 months). Most tumours were larger than 20 mm; invasive ductal carcinoma was of no special histological type and with an intermediate grade of differentiation. Almost half of the men were diagnosed with positive axillary lymph nodes (43.5%). Hormone receptor (HR) positivity was observed in 98.4% of the patients. Notably, DFS among men who did not receive tamoxifen was significantly reduced as compared with those who underwent tamoxifen therapy (P = 0.002). The recurrence rate and mortality in the group of patients without and with tamoxifen treatment were 18.2% and 11.2%, respectively. The most common localisation of metastases was the bone. After adjustment for prognostic factors, we found that tamoxifen was found to reduce the recurrence rate by 68% (hazard ratio HR = 0.32; 95% confidence interval, CI: 0.14-0.74).

CONCLUSIONS

Tamoxifen treatment was associated with improved DFS for MBC patients.

CLINICAL TRIAL REGISTRATION

DRKS00009536.

摘要

背景

由于缺乏前瞻性数据,目前男性乳腺癌(MBC)的治疗是基于从回顾性分析或从女性患者研究中推断出来的信息。在这项前瞻性入组的队列研究中,我们回顾性地检查了他莫昔芬对 MBC 患者的生存影响。

方法

在这项前瞻性入组的队列研究中,2009 年 5 月至 2018 年 6 月期间共治疗了 448 例 MBC 患者。主要终点是无病生存(DFS)。

结果

2009 年 5 月至 2018 年 6 月期间,共发现 448 例男性乳腺癌患者,诊断时的中位年龄为 69 岁(范围 27-96 岁)。中位随访时间为 39 个月(范围 3-89 个月)。大多数肿瘤大于 20mm;浸润性导管癌无特殊组织学类型,分化程度中等。近一半的男性患者诊断为腋窝淋巴结阳性(43.5%)。激素受体(HR)阳性率为 98.4%。值得注意的是,未接受他莫昔芬治疗的男性患者的 DFS 明显低于接受他莫昔芬治疗的患者(P=0.002)。未接受和接受他莫昔芬治疗的患者的复发率和死亡率分别为 18.2%和 11.2%。转移最常见的部位是骨骼。调整预后因素后,我们发现他莫昔芬可使复发率降低 68%(风险比 HR=0.32;95%置信区间,CI:0.14-0.74)。

结论

他莫昔芬治疗可改善 MBC 患者的 DFS。

临床试验注册

DRKS00009536。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7c0/7341811/77f69cee190f/41416_2020_857_Fig1_HTML.jpg

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