Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea.
Department of Surgery, Sacred Heart Hospital, Hallym University, Dongtan, Republic of Korea.
Sci Rep. 2020 Oct 8;10(1):16850. doi: 10.1038/s41598-020-74055-3.
This study aimed to validate the Clinical Treatment Score post-5 years (CTS5)-based risk stratification in a cohort comprising pre- and postmenopausal patients with estrogen receptor (ER)-positive breast cancer. We investigated the clinicopathologic parameters including Ki-67 labelling index (LI) to identify factors affecting late distant recurrence (DR). Women with ER-positive breast cancer who were free of DR for 5 years were identified between January 2004 and December 2009. We investigated the risk of late DR (5-10 years) according to the CTS5 risk group. Cox regression analysis was used to determine the prognostic performance of CTS5 and identify factors associated with late DR. In all, 680 women were included. Of these, 379 (55.7%) were premenopausal and 301 (44.3%) were postmenopausal. At a median follow-up of 118 months, 32 women had late DR. CTS5 was a significant prognostic factor for late DR in both pre- and postmenopausal women. In the low CTS5 group, high Ki-67 LI (> 20%) was a significant risk factor for late DR. CTS5 is a useful tool for assessing the risk of late DR in pre- and postmenopausal women with ER-positive breast cancer. Extended endocrine therapy can be considered in patients with high Ki-67 LI (> 20%) in the low CTS5 group.
本研究旨在验证基于临床治疗评分（CTS5）的风险分层在包含绝经前和绝经后雌激素受体（ER）阳性乳腺癌患者的队列中的有效性。我们研究了包括 Ki-67 标记指数（LI）在内的临床病理参数，以确定影响远处迟发性复发（DR）的因素。在 2004 年 1 月至 2009 年 12 月期间，确定了无 5 年 DR 的 ER 阳性乳腺癌女性。我们根据 CTS5 风险组调查了晚期 DR（5-10 年）的风险。使用 Cox 回归分析确定 CTS5 的预后性能并确定与晚期 DR 相关的因素。共有 680 名女性入组。其中，379 名（55.7%）为绝经前，301 名（44.3%）为绝经后。中位随访 118 个月时，有 32 名女性发生晚期 DR。在绝经前和绝经后女性中，CTS5 均是晚期 DR 的显著预后因素。在低 CTS5 组中，Ki-67 LI（>20%）较高是晚期 DR 的显著危险因素。在低 CTS5 组中，Ki-67 LI（>20%）较高的患者可以考虑延长内分泌治疗。
