接受以治愈为目的手术治疗且雌激素受体阳性、淋巴结阴性乳腺癌患者的疾病复发和肿瘤学结局。

Disease recurrence and oncological outcome of patients treated surgically with curative intent for estrogen receptor positive, lymph node negative breast cancer.

机构信息

The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland.

Department of Surgery, Galway University Hospitals, Galway, Ireland.

出版信息

Surg Oncol. 2021 Jun;37:101531. doi: 10.1016/j.suronc.2021.101531. Epub 2021 Jan 31.

DOI:10.1016/j.suronc.2021.101531

PMID:33545657

Abstract

BACKGROUND

The molecular era has identified four breast cancer subtypes. Luminal A breast cancer (LABC) is defined by estrogen-receptor positive (ER+), progesterone-receptor positive (PgR+) and human epidermal growth factor receptor-2 negative (HER2-) tumours; these cancers are the most common and carry favourable prognoses.

AIMS

To describe clinicopathologic features, oncological outcome and relapse patterns in LABC.

METHODS

Consecutive female patients diagnosed with ER/PgR+/HER2-, lymph node negative (LN-) breast cancer between 2005 and 2015 were included. Clinicopathological and recurrence data was recorded using descriptive statistics. Oncological outcome was determined using Kaplan-Meier and Cox-regression analyses.

RESULTS

Analysis was performed for 849 patients with median follow-up of 102.1 months. Mean disease-free (DFS) and overall survival (OS) were 85.8% and 91.8%. Seventy patients died during this study (8.2%), while 58 patients had recurrence; 7 had local recurrence (0.8%) and 51 had distant recurrence (DDR) (6.0%). Patients developing DDR were likely to be postmenopausal (P = 0.028), present symptomatically (P < 0.001) and have larger tumours (P < 0.001). The mean time to DDR was 65.7 months, with fatal recurrence occurring in 66.6% of patients with DDR (34/51). Systemic chemotherapy prescription did not influence DDR (P = 0.053). Age >65 (hazards ratio (HR):1.66, 95% Confidence Interval (CI):1.07-2.55, P = 0.022), presenting symptomatically (HR:2.28, 95%CI:1.21-4.29, P = 0.011) and tumour size >20 mm (HR:1.81, 95%CI:1.25-2.62, P = 0.002) predicted DFS, while age>65 (HR:2.60, 95%CI:1.49-4.53, P = 0.001) and being postmenopausal at diagnosis (HR:3.13, 95%CI:1.19-8.22, P = 0.020) predicted OS.

CONCLUSION

Our series demonstrated excellent survival outcomes for patients diagnosed with LN- LABC after almost a decade of follow-up. However, following DDR, fatal progression is often imminent.

摘要

背景

分子时代已经确定了四种乳腺癌亚型。Luminal A 型乳腺癌（LABC）的定义是雌激素受体阳性（ER+）、孕激素受体阳性（PgR+）和人表皮生长因子受体 2 阴性（HER2-）肿瘤；这些癌症最常见，预后良好。

目的

描述 LABC 的临床病理特征、肿瘤学结果和复发模式。

方法

连续纳入 2005 年至 2015 年间诊断为 ER/PgR+/HER2-、淋巴结阴性（LN-）乳腺癌的女性患者。使用描述性统计记录临床病理和复发数据。使用 Kaplan-Meier 和 Cox 回归分析确定肿瘤学结果。

结果

对 849 例中位随访时间为 102.1 个月的患者进行了分析。无病生存（DFS）和总生存（OS）的平均时间分别为 85.8%和 91.8%。研究期间有 70 名患者死亡（8.2%），58 名患者复发；7 名患者出现局部复发（0.8%），51 名患者出现远处复发（DDR）（6.0%）。出现 DDR 的患者更有可能绝经（P=0.028），表现为症状（P<0.001）和肿瘤更大（P<0.001）。DDR 的平均时间为 65.7 个月，51 例 DDR 中有 34 例（66.6%）发生致命性复发。全身化疗处方并未影响 DDR（P=0.053）。年龄>65 岁（危险比（HR）：1.66，95%置信区间（CI）：1.07-2.55，P=0.022）、出现症状（HR：2.28，95%CI：1.21-4.29，P=0.011）和肿瘤大小>20mm（HR：1.81，95%CI：1.25-2.62，P=0.002）预测 DFS，而年龄>65 岁（HR：2.60，95%CI：1.49-4.53，P=0.001）和绝经后诊断（HR：3.13，95%CI：1.19-8.22，P=0.020）预测 OS。