Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Kirrbergerstraße 100, 66424, Homburg/Saar, Germany.
Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical Center Freiburg, Freiburg, Germany.
Arch Gynecol Obstet. 2021 Oct;304(4):1065-1071. doi: 10.1007/s00404-021-06018-6. Epub 2021 Mar 10.
Pathologic complete response is associated with longer disease-free survival and better overall survival after neoadjuvant chemotherapy in breast cancer patients. We, therefore, evaluated factors influencing pathologic complete response.
Patients receiving neoadjuvant chemotherapy from 2015 to 2018 at the Saarland University Hospital were included. Patients' age, tumor stage, tumor biology, genetic mutation, recurrent cancer, discontinuation of chemotherapy, and participation in clinical trials were extracted from electronic medical records. Binary logistic regression was performed to evaluate the influence of these factors on pathologic complete response.
Data of 183 patients were included. The median patient's age was 54 years (22-78). The median interval between diagnosis and onset of chemotherapy was 28 days (14-91); between end of chemotherapy and surgery 28 days (9-57). Sixty-two patients (34%) participated in clinical trials for chemotherapy. A total of 86 patients (47%) achieved pathologic complete response. Patient's age, genetic mutation, recurrent cancers, or discontinuation of chemotherapy (due to side effects) and time intervals (between diagnosis and onset of chemotherapy, as well as between end of chemotherapy and surgery) did not influence pathologic complete response. Patients with high Ki67, high grading, Her2 positive tumors, as well as patients participating in clinical trials for chemotherapy had a higher chance of having pathologic complete response. Patients with Luminal B tumors had a lower chance for pathologic complete response.
Particularly patients with high risk cancer and patients, participating in clinical trials benefit most from chemotherapy. Therefore, breast cancer patients can be encouraged to participate in clinical trials for chemotherapy.
在接受新辅助化疗的乳腺癌患者中，病理完全缓解与无病生存时间延长和总生存时间改善相关。因此，我们评估了影响病理完全缓解的因素。
纳入 2015 年至 2018 年在萨尔兰大学医院接受新辅助化疗的患者。从电子病历中提取患者的年龄、肿瘤分期、肿瘤生物学、基因突变、复发性癌症、化疗中断和临床试验参与情况。采用二元逻辑回归分析这些因素对病理完全缓解的影响。
共纳入 183 例患者。患者的中位年龄为 54 岁（22-78 岁）。诊断与化疗开始之间的中位间隔为 28 天（14-91 天）；化疗结束与手术之间的中位间隔为 28 天（9-57 天）。62 例（34%）患者参加了化疗临床试验。共有 86 例（47%）患者达到病理完全缓解。患者年龄、基因突变、复发性癌症、化疗中断（因副作用）以及时间间隔（诊断与化疗开始之间以及化疗结束与手术之间）均不影响病理完全缓解。Ki67 高、分级高、Her2 阳性肿瘤以及参加化疗临床试验的患者发生病理完全缓解的几率更高。Luminal B 型肿瘤患者发生病理完全缓解的几率较低。
高风险癌症患者和参加化疗临床试验的患者受益最大，因此应鼓励乳腺癌患者参加化疗临床试验。
