腔面 A 型乳腺癌的新辅助化疗：预测组织病理学反应和肿瘤学结局的因素。
Neoadjuvant chemotherapy for luminal a breast cancer: Factors predictive of histopathologic response and oncologic outcome.
机构信息
Department of Breast Surgery, University Hospital Galway, Galway, Ireland.
Department of Breast Surgery, University Hospital Galway, Galway, Ireland; Lambe Institute for Translational Research, National University of Ireland Galway, University Road, Galway, Ireland.
出版信息
Am J Surg. 2021 Aug;222(2):368-376. doi: 10.1016/j.amjsurg.2020.11.053. Epub 2020 Dec 9.
BACKGROUND
The benefit of chemotherapy (NAC) for patients with ER/PR positive, HER2 negative breast cancer is unclear. Our aim was to determine factors associated with histopathologic response and oncologic outcome following NAC in this group.
METHODS
Consecutive female patients undergoing neoadjuvant therapy and surgery for locally advanced Luminal A breast cancer between 2010 and 2015 were studied. Multivariable linear, logistic, and Cox regression analysis was undertaken.
RESULTS
114 patients were studied. Pathological complete response (pCR) was achieved in 7.9% of patients, ypN0 in 25.5%, and downstaging in 33.6%. However, 43.9% exhibited a Sataloff C-D response. Tumor grade independently predicted pCR (P = 0.039), while PR score predicted ypN0 (P = 0.017) and downstaging (P=0.029). 5-year invasive disease-free (iDFS) and overall survival (OS) were 68.5 ± 4.7% and 77.7 ± 4.3%, respectively.
CONCLUSION
After NAC for Luminal A breast cancer, pCR rates are low. Patients with high grade tumors with weak PR expression exhibit the most promising response rates.
背景
对于 ER/PR 阳性、HER2 阴性的乳腺癌患者，化疗（NAC）的获益尚不清楚。我们的目的是确定这组患者接受新辅助化疗后与组织病理学反应和肿瘤学结局相关的因素。
方法
连续纳入 2010 年至 2015 年间接受新辅助治疗和手术的局部晚期 Luminal A 型乳腺癌的女性患者进行研究。采用多变量线性、逻辑和 Cox 回归分析。
结果
研究了 114 例患者。病理完全缓解（pCR）的患者占 7.9%，ypN0 的患者占 25.5%，降期的患者占 33.6%。然而，43.9%的患者表现出 Sataloff C-D 反应。肿瘤分级独立预测 pCR（P=0.039），而 PR 评分预测 ypN0（P=0.017）和降期（P=0.029）。5 年无侵袭性疾病生存（iDFS）和总生存（OS）分别为 68.5±4.7%和 77.7±4.3%。
结论
Luminal A 型乳腺癌患者接受 NAC 治疗后，pCR 率较低。肿瘤分级高、PR 表达弱的患者具有最有希望的反应率。
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