Chen Weilin, Wu Jiayi, Zhu Yifei, Huang Jiahui, Chen Xiaosong, Huang Ou, He Jianrong, Li Yafen, Chen Weiguo, Shen Kunwei, Zhu Li
Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Thyroid and Breast Surgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Front Oncol. 2023 Jan 12;12:996522. doi: 10.3389/fonc.2022.996522. eCollection 2022.
In our study, we aim to analyze the impact of clinicopathological factors on the recommendation of extended endocrine therapy (EET) in patients with ER+ breast cancer and to retrospectively validate the value of CTS5 in EET decision making.
The retrospective analysis was performed in patients with ER+ breast cancer who have finished 4.5-5 years of adjuvant endocrine therapy and undergone MDT discussion from October 2017 to November 2019. Multivariate logistic regression was used to identify the independent factors for treatment recommendation. CTS5 was calculated for retrospective validation of the EET decision making.
Two hundred thirty-five patients were received; 4.5-5 years of adjuvant endocrine therapy were included in the study. Multivariate analysis suggested that age (OR 0.460, 95% CI 0.219-0.965, 0.04), pN (OR 39.350, 95% CI 9.831-157.341, < 0.001), and receipt of chemotherapy (OR 3.478, 95% CI 1.336-9.055, 0.011) were independent predictors for the recommendation of EET. In the previously selective estrogen receptor modulator (SERM)-treated subgroup, pN and receipt of chemotherapy were independent predictors for the recommendation of EET. In the previously AI-treated subgroup, age, pN, and receipt of chemotherapy were independent predictors. Adverse events did not affect the recommendation in patients previously treated with adjuvant endocrine treatment nor in the previously SERM or AI-treated subgroups. CTS5 (OR 21.887, 95% CI 2.846-168.309, 0.003) remained an independent predictor for the recommendation of EET.
Our study indicated that age, lymph nodal status, and receipt of chemotherapy were independent predictors for the recommendation of EET. The application of the CTS5 on EET decision making might be valuable among ER+ breast cancer patients.
在我们的研究中，我们旨在分析临床病理因素对雌激素受体阳性（ER+）乳腺癌患者延长内分泌治疗（EET）推荐的影响，并回顾性验证CTS5在EET决策中的价值。
对2017年10月至2019年11月期间完成4.5 - 5年辅助内分泌治疗并接受多学科团队（MDT）讨论的ER+乳腺癌患者进行回顾性分析。采用多因素逻辑回归分析确定治疗推荐的独立因素。计算CTS5以回顾性验证EET决策。
共纳入235例接受了4.5 - 5年辅助内分泌治疗的患者。多因素分析表明，年龄（比值比[OR]0.460，95%置信区间[CI]0.219 - 0.965，P = 0.04）、pN（OR 39.350，95% CI 9.831 - 157.341，P < 0.001）和是否接受化疗（OR 3.478，95% CI 1.336 - 9.055，P = 0.011）是EET推荐的独立预测因素。在先前接受选择性雌激素受体调节剂（SERM）治疗的亚组中，pN和是否接受化疗是EET推荐的独立预测因素。在先前接受芳香化酶抑制剂（AI）治疗的亚组中，年龄、pN和是否接受化疗为独立预测因素。不良事件并未影响先前接受辅助内分泌治疗患者的推荐，也未影响先前接受SERM或AI治疗亚组患者的推荐。CTS5（OR 21.887，95% CI 2.846 - 168.309，P = 0.003）仍然是EET推荐的独立预测因素。
我们的研究表明，年龄、淋巴结状态和是否接受化疗是EET推荐的独立预测因素。CTS5在EET决策中的应用对于ER+乳腺癌患者可能具有重要价值。
