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[三阴性乳腺癌新辅助化疗后疗效的临床意义——与预后的相关性]

[Clinical Significance of the Curative Effect after Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer-Correlation to Prognosis].

作者信息

Haku Ei, Kojima Yasuyuki, Sakamaki Kaori, Kitajima Mina, Takishita Mariko, Sakamoto Nao, Tazou Mizuho, Nakano Mari, Kuroda Takako, Yoshie Reiko, Tsuruga Tomoko, Shimo Ayaka, Shimo Arata, Motoyoshi Ai, Kawamoto Hisanori, Fukuda Mamoru, Tsugawa Koichiro

机构信息

Breast & Imaging Center, St. Marianna University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 2020 Oct;47(10):1449-1455.

Abstract

We investigated factors related to the recurrence and prognosis of patients with triple-negative breast cancer (TNBC)after neoadjuvant chemotherapy(NAC). Of the 545 patients who underwent surgery after NAC between January 2013 and December 2016, 131 patients had TNBC. An analysis of each TNBC case indicated that the presence or absence of clinical lymph node metastasis(cN)before treatment might be a predictive factor of prognosis. There were 57(43.5%)pathological complete response(pCR)(ypT0 or ypTis/N0)cases after NAC. Overall survival(OS)and disease free survival(DFS) were significantly better in pCR cases than in non-pCR cases. However, recurrence was observed in 8 of 57(14%)pCR cases and 29 of 74(39%)non-pCR cases. The factors defining DFS from the univariate analysis of the non-pCR group were cN, ypT, ypN, and vascular invasion. The multivariate analysis of these factors suggested that residual cN and vascular invasion might be independent factors predicting DFS. Residual vascular invasion was found to predict OS, and was considered to be a poor prognostic factor.

摘要

我们研究了新辅助化疗(NAC)后三阴性乳腺癌(TNBC)患者复发及预后的相关因素。在2013年1月至2016年12月期间接受NAC后手术的545例患者中,131例为TNBC。对每例TNBC病例的分析表明,治疗前临床淋巴结转移(cN)的有无可能是预后的一个预测因素。NAC后有57例(43.5%)达到病理完全缓解(pCR)(ypT0或ypTis/N0)。pCR病例的总生存期(OS)和无病生存期(DFS)显著优于非pCR病例。然而,57例pCR病例中有8例(14%)出现复发,74例非pCR病例中有29例(39%)出现复发。非pCR组单因素分析确定DFS的因素为cN、ypT、ypN和血管侵犯。对这些因素的多因素分析表明,残留cN和血管侵犯可能是预测DFS的独立因素。发现残留血管侵犯可预测OS,被认为是一个不良预后因素。

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