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T1a/b N0三阴性乳腺癌患者治疗模式及自然病史的回顾性研究:单机构经验

Retrospective Study of Treatment Patterns and Natural History of Patients with T1a/b N0 Triple-Negative Breast Cancers: A Single-Institution Experience.

作者信息

Liu Langfeier, Lewis Nicholas, Sun Weihong, Whiting Junmin, Hoover Susan, Costa Ricardo L B

机构信息

Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.

Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.

出版信息

Oncology. 2023;101(12):765-772. doi: 10.1159/000533149. Epub 2023 Aug 1.

Abstract

INTRODUCTION

T1a/b, node-negative (node-), triple-negative breast cancers (TNBCs) are underrepresented in randomized drug-approving clinical trials. Given their low incidence, the clinicopathological features, natural history, and treatment patterns of these tumors remain insufficiently understood.

METHODS

We conducted a single-institution retrospective cohort study of patients with T1a/b, N0, M0 TNBCs. Deidentified patient- and tumor-related data were collected and summarized. Kruskal-Wallis, χ2, or Fisher exact tests were used to evaluate associations of interest. Kaplan-Meier methods, log-rank tests, and Cox's proportional hazards models were applied for survival analyses.

RESULTS

Of 108 cases of node- TNBCs measuring ≤2 cm, 34 node- T1a/b tumors were included in our analysis. All cases had an intermediate to high histological grade, and most had a Ki-67 score of ≥20%. All patients received adjuvant chemotherapy, and many underwent mastectomy (47%). Docetaxel combined with cyclophosphamide was the most common adjuvant chemotherapy regimen (75%). We did not observe significant associations between improved outcomes and treatment with anthracycline-containing regimens. Among patients with node- pT1a/b tumors, the estimated 3-year recurrence-free survival (RFS) and distant RFS rates were both 96.3% (95% CI: 76.5-99.5), and the overall survival rate was estimated to be 100% (95% CI: 100-100). There were no cases of local recurrences observed.

CONCLUSIONS

In our cohort, all patients with T1a/b node- TNBCs were treated with adjuvant chemotherapy and had favorable outcomes even when treated with anthracycline-sparing regimens.

摘要

引言

T1a/b期、无淋巴结转移(N0)的三阴性乳腺癌(TNBC)在随机药物审批临床试验中的代表性不足。鉴于其发病率较低,这些肿瘤的临床病理特征、自然史和治疗模式仍未得到充分了解。

方法

我们对T1a/b期、N0、M0的TNBC患者进行了单机构回顾性队列研究。收集并汇总了去识别化的患者和肿瘤相关数据。使用Kruskal-Wallis检验、χ²检验或Fisher精确检验来评估感兴趣的关联。采用Kaplan-Meier方法、对数秩检验和Cox比例风险模型进行生存分析。

结果

在108例最大径≤2 cm的N0 TNBC病例中,34例N0 T1a/b肿瘤纳入我们的分析。所有病例的组织学分级为中高级,大多数病例的Ki-67评分≥20%。所有患者均接受辅助化疗,许多患者接受了乳房切除术(47%)。多西他赛联合环磷酰胺是最常见的辅助化疗方案(75%)。我们未观察到含蒽环类方案治疗与改善预后之间存在显著关联。在N0 pT1a/b肿瘤患者中,估计3年无复发生存率(RFS)和远处RFS率均为96.3%(95%CI:76.5-99.5),总生存率估计为100%(95%CI:100-100)。未观察到局部复发病例。

结论

在我们的队列中,所有T1a/b期N0 TNBC患者均接受了辅助化疗,即使采用不含蒽环类的方案治疗,预后也良好。

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