Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.
BMC Womens Health. 2022 Jul 4;22(1):268. doi: 10.1186/s12905-022-01846-3.
Today, with the progress of medical sciences, increasing the cure probability and survival time is an important goal of cancer treatment. This study compared long-term disease-free survival (DFS) of non-metastatic breast cancer patients based on different molecular subtypes.
This retrospective cohort study consisted of 1287 patients diagnosed with breast cancer and treated at Motamed Cancer Institute from 2000 to 2016 and followed up until 2018. Kaplan-Meier curve was fitted to data based on molecular subtypes. Then the semi-parametric mixture cure model was applied to determine the survival and cure probability of molecular subtypes by adjusting clinical and demographic factors.
Among 1287 breast cancer patients, 200 (15.5%) cases died. The mean age of patients was 47.00 ± 10.72 years. Women with the HR+/HER2-subtype had the best 5-year survival rate (84.2%), whereas other subtypes had a lower rate as follows: HR+/HER2+ (77.3%), triple-negative (76.5%), and HR-/HER2+ (62.3%). Kaplan-Meier curve calculated a cure rate of about 60% and patients who survived more than 150 months were intuitively considered cured. After adjustment for clinical and demographic variables, the cure probability of HR-/Her2+ patients was substantially lower than HR+/HER2- patients (OR = 0.22), though there were no significant variations in short-term DFS based on molecular subtypes (HR = 0.91).
Our results confirm that the most prevalent breast cancer was HR+/HER2- tumor type which had the best prognosis. It is also concluded that HR-/HER2+ patients had the worst outcomes, with the highest rates of recurrence and metastasis and the lowest overall and disease-free survival rates.
如今，随着医学科学的进步，提高治愈率和生存时间是癌症治疗的一个重要目标。本研究比较了不同分子亚型的非转移性乳腺癌患者的长期无病生存（DFS）。
这项回顾性队列研究包括 2000 年至 2016 年在莫塔梅德癌症研究所诊断为乳腺癌并接受治疗的 1287 例患者，并随访至 2018 年。根据分子亚型拟合 Kaplan-Meier 曲线。然后应用半参数混合治愈模型，通过调整临床和人口统计学因素来确定分子亚型的生存和治愈概率。
在 1287 例乳腺癌患者中，有 200 例（15.5%）死亡。患者的平均年龄为 47.00±10.72 岁。HR+/HER2- 亚型的女性 5 年生存率最高（84.2%），而其他亚型的生存率较低，依次为 HR+/HER2+（77.3%）、三阴性（76.5%）和 HR-/HER2+（62.3%）。Kaplan-Meier 曲线计算出的治愈率约为 60%，超过 150 个月存活的患者直观上被认为是治愈的。在调整临床和人口统计学变量后，HR-/HER2+患者的治愈率明显低于 HR+/HER2-患者（OR=0.22），而基于分子亚型的短期 DFS 没有显著差异（HR=0.91）。
我们的结果证实，最常见的乳腺癌是 HR+/HER2-肿瘤类型，其预后最好。还得出结论，HR-/HER2+患者的结局最差，复发和转移率最高，总生存率和无病生存率最低。
