年轻绝经前乳腺癌患者的预处理内分泌症状与无复发生存率：一项前瞻性队列研究
Pretreatment endocrine symptoms and recurrence-free survival among young premenopausal patients with breast cancer: a prospective cohort study.
作者信息
Kang Danbee, Cho Juhee, Park Seri, Kim Hyo Jung, Kim Seok Won, Lee Jeong Eon, Yu Jonghan, Lee Se Kyung, Kim Ji-Yeon, Nam Seok Jin, Park Yeon Hee
机构信息
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
出版信息
Ther Adv Med Oncol. 2023 Aug 1;15:17588359231189421. doi: 10.1177/17588359231189421. eCollection 2023.
BACKGROUND
Pretreatment endocrine symptoms in premenopausal patients might be considered as a potential marker of poor prognosis. We conducted a cohort study to evaluate the association between endocrine symptoms prior to treatment and recurrence-free survival (RFS) among premenopausal patients with breast cancer aged ⩽40 years.
METHODS
Data were obtained from a prospective cohort study (NCT03131089) conducted at the Samsung Medical Center from 2013 to 2021. We included patients aged ⩽40 years who had been diagnosed with breast cancer. The primary outcome measure was RFS. Endocrine symptoms were measured using the Functional Assessment of Cancer Therapy - Endocrine Symptoms (FACT-ES). We also calculated the hazard ratio (HR) for recurrence or all-cause mortality by comparing the tertiles of the FACT-ES score at diagnosis.
RESULTS
Among the 977 participants, the mean (standard deviation) age was 35.3 (3.9) years. At diagnosis, 17.2% of the patients had at least one severe endocrine symptom. During 3512 person-years of follow-up, the high symptom group had a worse RFS than the low-symptom group [HR = 2.05; 95% confidence interval (CI) = 1.19-3.54]. In particular, hot flashes (HR = 5.59; 95% CI = 1.96-15.93) and breast sensitivity (HR = 1.82; 95% CI = 1.00-3.32) were associated with reduced RFS.
CONCLUSION
Close monitoring of pretreatment endocrine symptoms may be important in patients diagnosed with breast cancer at a young age.
背景
绝经前患者的治疗前内分泌症状可能被视为预后不良的潜在标志物。我们进行了一项队列研究，以评估年龄≤40岁的绝经前乳腺癌患者治疗前内分泌症状与无复发生存期（RFS）之间的关联。
方法
数据来自2013年至2021年在三星医疗中心进行的一项前瞻性队列研究（NCT03131089）。我们纳入了年龄≤40岁且被诊断为乳腺癌的患者。主要结局指标是RFS。使用癌症治疗功能评估-内分泌症状量表（FACT-ES）测量内分泌症状。我们还通过比较诊断时FACT-ES评分的三分位数来计算复发或全因死亡率的风险比（HR）。
结果
在977名参与者中，平均（标准差）年龄为35.3（3.9）岁。诊断时，17.2%的患者至少有一种严重的内分泌症状。在3512人年的随访期间，高症状组的RFS比低症状组更差[HR = 2.05；95%置信区间（CI）= 1.19 - 3.54]。特别是潮热（HR = 5.59；95% CI = 1.96 - 15.93）和乳房敏感（HR = 1.82；95% CI = 1.00 - 3.32）与RFS降低相关。
结论
对于年轻的乳腺癌确诊患者，密切监测治疗前内分泌症状可能很重要。
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