Wu Junzhao, Lv Minhao, Yuan Peng, Ma Youzhao, Tian Peiqi, Li Lianfang, Wang Chengzheng, Lu Zhenduo, Yan Min, Chen Xiuchun, Liu Zhenzhen
Department of Breast Disease, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
Gland Surg. 2022 Aug;11(8):1341-1355. doi: 10.21037/gs-22-409.
There are limited published studies on the prognostic predictors and the value of adjuvant chemotherapy (CT) in T1a,bN0M0 triple-negative breast cancer (TNBC) after local therapy. Therefore, the aim of the present study was to explore the prognostic predictors and the value of adjuvant CT in this population.
We identified T1a,bN0M0 TNBC cases registered in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. We analyzed associations between patient characteristics and overall survival (OS) and breast cancer-specific mortality (BCSM), and differences in OS and BCSM in a CT and no chemotherapy (no CT) cohort before and after propensity score matching.
Of the 3,065 SEER patients, 1,534 (50.0%) received adjuvant CT. The median follow up was 57 months (interquartile range: 39-75 months). The 5-year OS and cumulative BCSM were 93.6% and 3.3%, respectively. Younger age was not associated with lower OS or higher BCSM in the total and no CT cohorts. Higher histologic grade was associated with lower OS in the no CT cohort, and T1b tumors were associated with higher BCSM in the total cohort. Multivariable analysis showed no association between adjuvant CT and OS or BCSM.
Patients with T1a,bN0M0 TNBC had an excellent prognosis with or without adjuvant CT. For this population, higher histologic grade and larger tumor size were predictors of poor prognosis, although the effect of age was complex. Our data did not support using adjuvant CT in patients with T1a,bN0M0 TNBC.
关于局部治疗后T1a、bN0M0三阴性乳腺癌(TNBC)的预后预测因素及辅助化疗(CT)价值的已发表研究有限。因此,本研究旨在探讨该人群的预后预测因素及辅助CT的价值。
我们确定了2010年至2015年间在监测、流行病学和最终结果(SEER)数据库中登记的T1a、bN0M0 TNBC病例。我们分析了患者特征与总生存期(OS)和乳腺癌特异性死亡率(BCSM)之间的关联,以及倾向评分匹配前后CT组和非化疗(无CT)组在OS和BCSM方面的差异。
在3065例SEER患者中,1534例(50.0%)接受了辅助CT。中位随访时间为57个月(四分位间距:39 - 75个月)。5年OS率和累积BCSM分别为93.6%和3.3%。在总体人群和无CT组中,年龄较小与较低的OS或较高的BCSM无关。在无CT组中,较高的组织学分级与较低的OS相关,在总体人群中,T1b肿瘤与较高的BCSM相关。多变量分析显示辅助CT与OS或BCSM之间无关联。
T1a、bN0M0 TNBC患者无论是否接受辅助CT预后均良好。对于该人群,较高的组织学分级和较大的肿瘤大小是预后不良的预测因素,尽管年龄的影响较为复杂。我们的数据不支持对T1a、bN0M0 TNBC患者使用辅助CT。