老年患者高危乳腺癌的评估：PREDICT评分与TAILORx风险分类的比较分析
Assessment High-Risk Breast Cancer in Older Patients: A Comparative Analysis of PREDICT Scores and TAILORx Risk Categorization.
作者信息
Ünal Çağlar, Özmen Tolga, Ordu Çetin, Uras Cihan, Kara Halil, Gökmen Erhan, Özdoğan Mustafa, Demircan Orhan, Pilancı Kezban Nur, Duymaz Tomris, Özmen Vahit
机构信息
Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey.
Department of Gastrointestinal and Oncologic Surgery, Harvard Medical School, Massachusetts, USA.
出版信息
Eur J Breast Health. 2023 Oct 1;19(4):325-330. doi: 10.4274/ejbh.galenos.2023.2023-8-5. eCollection 2023 Oct.
OBJECTIVE
This study aimed to evaluate the relationship between PREDICT tool overall survival (OS) scores and high-risk patients according to TAILORx risk categorization in elderly hormone reseptor (HR) positive human epidermal growth factor negative early breast-cancer patients.
MATERIALS AND METHODS
We conducted a retrospective study, extracting data from medical records of 64 patients diagnosed with breast cancer. A retrospective analysis was performed on all patients who had Oncotype Dx Recurrence Scores across five medical centers between 2017 and 2022. PREDICT scores were defined as calculated 10-year OS rates via PREDICT tool.
RESULTS
The median age of the patients was 67, with a range between 65-75 years. Low-risk patients had a slightly higher two PREDICT scores compared to high-risk patients (78% vs. 73%), (81% vs. 77%), which were statistically significant. The progesterone receptor (PR) level was significantly lower in the high-risk group (3.5% vs. 80%). A unit decrease in the PREDICT scores was associated with a 11% increase in the odds of being in the high-risk group. However, these effects weren't statistically significant in the multivariate analysis. A unit decrease in the PR level was significantly associated with increased odds (by 5% in the multivariate analysis) of being in the high-risk group.
CONCLUSION
Our study underscores the importance of using a combination of tools, including the PREDICT tool, PR levels, and TAILORx risk categorization, for a comprehensive risk assessment in these patients, especially in the older population. Accurate risk assessment is crucial for tailoring the treatment and optimizing outcomes in this vulnerable population. Future studies are warranted to further validate these findings in larger cohorts and to explore additional biomarkers and genomic signatures that may aid in the risk assessment and management of breast cancer in older patients.
目的
本研究旨在评估在老年激素受体（HR）阳性、人表皮生长因子阴性的早期乳腺癌患者中，根据TAILORx风险分类，PREDICT工具的总生存（OS）评分与高危患者之间的关系。
材料与方法
我们进行了一项回顾性研究，从64例乳腺癌确诊患者的病历中提取数据。对2017年至2022年期间五个医疗中心所有有Oncotype Dx复发评分的患者进行回顾性分析。PREDICT评分定义为通过PREDICT工具计算的10年OS率。
结果
患者的中位年龄为67岁，范围在65 - 75岁之间。低危患者的两个PREDICT评分略高于高危患者（78%对73%），（81%对77%），具有统计学意义。高危组的孕激素受体（PR）水平显著较低（3.5%对80%）。PREDICT评分每降低一个单位，处于高危组的几率增加11%。然而，在多变量分析中这些影响无统计学意义。PR水平每降低一个单位，处于高危组的几率显著增加（多变量分析中增加5%）。
结论
我们的研究强调了使用包括PREDICT工具、PR水平和TAILORx风险分类等工具组合，对这些患者进行全面风险评估的重要性，尤其是在老年人群中。准确的风险评估对于为这一脆弱人群量身定制治疗方案并优化治疗结果至关重要。未来有必要开展进一步研究，在更大的队列中进一步验证这些发现，并探索可能有助于老年乳腺癌患者风险评估和管理的其他生物标志物和基因组特征。
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