Eom Yong Hwa, Yoon Chang Ik, Kang Young Joon, Jeon Ye Won
Division of Breast Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Breast Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
World J Surg Oncol. 2023 Mar 27;21(1):105. doi: 10.1186/s12957-023-02991-1.
Although the incidence of isolated ipsilateral local and regional recurrence (IILRR) in human epidermal growth factor 2 (HER2)-negative luminal breast cancer is low, it is important because of its potential risk of distant metastasis and breast cancer related mortality. The aim of this study was to investigate prognostic factor and survival of IILRR using a large multi-center cohort.
Data on patients with HER2-negative luminal breast cancer between 2005 and 2015 were retrieved. The endpoint was IILRR rate, post-recurrence progression-free survival (P-PFS), and post-recurrence overall survival (P-OS). Prognostic factors for progression and overall survival (OS) after IILRR were assessed by multivariate analysis.
Eighty (2.37%) patients experienced IILRR. Of them, 27 (33.7%) experienced a disease progression, including 23 (85.2%) who had distant metastasis. The median DFS was 48.5 months (range, 4-138 months). In 72.5% of cases, the first IILRR occurred after 3 years. Estimated 5-year P-PFS rates were 86.2%, 69.7%, 69.0%, 42.7%, and 82.2% for patients with age < 40 at diagnosis (p = 0.015), T1 stage (p = 0.012), stage I (p < 0.001), lymphovascular invasion (p = 0.003), and patients with post-recurrence endocrine therapy (p < 0.001), respectively. The 5-year Kaplan-Meier P-OS rate for patients was 81.4%. Post-recurrence endocrine therapy was independent factor for progression (HR: 0.176, p < 0.001) and OS (HR: 0.080, p < 0.001).
Although there is no standardized treatment for IILRR yet, endocrine therapy after local resection plays a more important role in improving prognosis than chemotherapy or radiotherapy in HER2-negative luminal breast cancer.
尽管人表皮生长因子2（HER2）阴性的管腔型乳腺癌单纯同侧局部和区域复发（IILRR）的发生率较低，但因其存在远处转移和乳腺癌相关死亡的潜在风险，所以仍很重要。本研究的目的是使用一个大型多中心队列来调查IILRR的预后因素和生存率。
检索2005年至2015年间HER2阴性管腔型乳腺癌患者的数据。终点指标为IILRR率、复发后无进展生存期（P-PFS）和复发后总生存期（P-OS）。通过多因素分析评估IILRR后进展和总生存期（OS）的预后因素。
80例（2.37%）患者发生IILRR。其中，27例（33.7%）出现疾病进展，包括23例（85.2%）发生远处转移。中位无病生存期为48.5个月（范围4 - 138个月）。在72.5%的病例中，首次IILRR发生在3年后。诊断时年龄<40岁（p = 0.015）、T1期（p = 0.012）、I期（p < 0.001）、淋巴管浸润（p = 0.003）以及复发后接受内分泌治疗的患者（p < 0.001），其估计的5年P-PFS率分别为86.2%、69.7%、69.0%、42.7%和82.2%。患者的5年Kaplan-Meier P-OS率为81.4%。复发后内分泌治疗是进展（风险比：0.176，p < 0.001）和OS（风险比：0.080，p < 0.001）的独立因素。
尽管IILRR尚无标准化治疗方法，但在HER2阴性管腔型乳腺癌中，局部切除后的内分泌治疗在改善预后方面比化疗或放疗发挥着更重要的作用。
