Cheng Ran, Kong Xiangyi, Wang Xiangyu, Fang Yi, Wang Jing
Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2020 Oct 30;10:1583. doi: 10.3389/fonc.2020.01583. eCollection 2020.
To explore the distribution of Oncotype DX Breast Recurrence Score (RS), the proportion of receiving chemotherapy, and the relationship between RS and chemotherapy benefit according to detailed age groups in women with hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-negative (HR+/HER2-/N0) breast cancer. This was an extensive, comprehensive, population-based retrospective study. Data on individuals with breast cancer were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program. The cohort was divided into five groups by age (≤ 35, 36-50, 51-65, 66-80, >80 years). RS distribution and chemotherapy proportion among different age groups were analyzed, and the overall survivals between patients receiving chemotherapy and those not/unknown were compared in each age group. The study cohort comprised 49,539 patients and the largest age group was 51-65 years. The percentage of patients with low-risk RS (0-10) increased with age, whereas those with intermediate-risk RS (11-25) decreased with age (except for the group of 36-50 years, which had the highest rate of intermediate-risk RS). The age group ≤35 years has the greatest rate of high-risk RS (26-100). The proportion of receiving chemotherapy decreased with age in all RS risk categories. Overall survival was benefited by chemotherapy only in the age group of 66-80 years with intermediate- and high-risk RS, and chemotherapy seemed to do more harm than good for patients older than 80 years. In the present study, we identified the distribution of RS, the proportion of receiving chemotherapy, and the relationship between RS and chemotherapy benefit according to a detailed age grouping for women with HR+/HER2-/N0 breast cancer, which may help in making individualized clinical decisions.
为了探究激素受体阳性、人表皮生长因子受体2阴性、无淋巴结转移(HR+/HER2-/N0)乳腺癌女性患者中,不同年龄组的Oncotype DX乳腺癌复发评分(RS)分布、接受化疗的比例以及RS与化疗获益之间的关系。这是一项基于人群的广泛、全面的回顾性研究。乳腺癌患者的数据来自监测、流行病学和最终结果(SEER)计划。该队列按年龄分为五组(≤35岁、36 - 50岁、51 - 65岁、66 - 80岁、>80岁)。分析不同年龄组的RS分布和化疗比例,并比较各年龄组接受化疗与未接受化疗/情况不明患者的总生存率。该研究队列包括49539名患者,最大年龄组为51 - 65岁。低风险RS(0 - 10)患者的百分比随年龄增加而升高,而中风险RS(11 - 25)患者的百分比随年龄下降(36 - 50岁组除外,该组中风险RS发生率最高)。≤35岁年龄组高风险RS(26 - 100)的发生率最高。在所有RS风险类别中,接受化疗的比例均随年龄下降。仅在66 - 80岁中风险和高风险RS的年龄组中,化疗对总生存有益,而对于80岁以上的患者,化疗似乎弊大于利。在本研究中,我们确定了HR+/HER2-/N0乳腺癌女性患者按详细年龄分组的RS分布、接受化疗的比例以及RS与化疗获益之间的关系,这可能有助于做出个体化的临床决策。