Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2022 Mar;38(3):277-282. doi: 10.1002/kjm2.12475. Epub 2021 Nov 25.
This study aimed to investigate the effectiveness of neoadjuvant chemotherapy in patients with breast cancer in different age groups and evaluate the impact of age group on survival outcome according to different treatment responses. Data were retrospectively collected from the cancer registry database of Kaohsiung Medical University Hospital in Taiwan under an approved protocol. Overall, 96 elder patients (aged >50 years) and 96 younger controls (aged ≤50 years) who received neoadjuvant chemotherapy and breast surgical treatment were examined after 1:1 matching. Logistic regression analysis was used to investigate the effectiveness of treatment response in patients of different age groups. Additionally, the Kaplan-Meier estimator and log-rank test were performed to evaluate the effect of age group and treatment response on disease-free and overall survival (OS). Although no direct significant association was found between age group and treatment response, several significant results were found in treatment response stratification analysis. Among 16 pathological complete response (pCR) patients, elder patients showed significantly greater 5-year disease-free survival (DFS) than younger patients (DFS rate, 85.7% vs. 0%, p = 0.041). However, in 176 non-pCR patients, elder patients showed poor DFS compared to younger patients (DFS rate, 16.6% vs. 32.3%; log-rank test, p = 0.031). With limited sample size and study design, our study results demonstrate that patients aged >50 years who achieved pCR after neoadjuvant chemotherapy could obtain better survival outcome than younger patients. However, the younger patients showed no survival benefits regardless of pCR status.
本研究旨在探讨新辅助化疗在不同年龄组乳腺癌患者中的疗效，并根据不同治疗反应评估年龄组对生存结果的影响。数据是通过经批准的协议从台湾高雄医学大学附属医院的癌症登记数据库中回顾性收集的。总体而言，96 名老年患者（年龄>50 岁）和 96 名年轻对照组（年龄≤50 岁）在接受新辅助化疗和乳房手术治疗后进行了 1:1 匹配。采用逻辑回归分析探讨不同年龄组患者治疗反应的有效性。此外，还使用 Kaplan-Meier 估计器和对数秩检验评估年龄组和治疗反应对无病生存和总生存（OS）的影响。尽管未发现年龄组与治疗反应之间存在直接显著关联，但在治疗反应分层分析中发现了一些显著结果。在 16 例病理完全缓解（pCR）患者中，老年患者的 5 年无病生存率（DFS）明显高于年轻患者（DFS 率，85.7%对 0%，p=0.041）。然而，在 176 例非 pCR 患者中，老年患者的 DFS 明显差于年轻患者（DFS 率，16.6%对 32.3%；对数秩检验，p=0.031）。由于样本量有限和研究设计，我们的研究结果表明，接受新辅助化疗后达到 pCR 的>50 岁患者比年轻患者获得更好的生存结果。然而，无论 pCR 状态如何，年轻患者均未显示出生存获益。
