Liu Ke, Li Guan-Qiao, Li Si-Qi, Chen Xue-Qin, Wu San-Gang
Xiamen Key Laboratory of Clinical Efficacy and Evidence Studies of Traditional Chinese Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Breast Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.
Breast. 2025 Feb;79:103873. doi: 10.1016/j.breast.2025.103873. Epub 2025 Jan 2.
To investigate the clinical value of Clinical Treatment Score Post-5 Years (CTS5) to predict the survival benefits of postmastectomy radiotherapy (PMRT) of patients with T1-2N1 luminal breast cancer (BC).
Patients who were diagnosed with T1-2N1 luminal BC between 2010 and 2015 were included in the Surveillance, Epidemiology, and End Results database. The chi-square test, binomial logistic regression, Kaplan-Meier analysis, and multivariable Cox proportional hazard model were used for statistical analyses.
A total of 11190 patients were included with a median follow-up time of 76 months. Regarding the CTS5 classification, 1641 (14.7 %), 3915 (35.0 %), and 5633 (50.3 %) patients had low-risk, intermediate-risk, and high-risk diseases, respectively. Patients with younger age, T2 stage, higher tumor grade, a higher number of positive lymph nodes, infiltrating lobular carcinoma subtype, and receipt of chemotherapy were associated with the receipt of PMRT (all P < 0.05). The multivariate analysis showed that the receipt of PMRT was the independent prognostic factor associated with better BCSS (P = 0.005) and OS (P < 0.001). The sensitivity analysis showed that PMRT did not improve BCSS (low-risk, P = 0.932; intermediate-risk, P = 0.952) and OS (low-risk, P = 0.637; intermediate-risk, P = 0.825) compared to those without PMRT in the low-risk and intermediate-risk groups. However, PMRT improved BCSS (P = 0.003) and OS (P < 0.001) in those with high-risk groups compared to those without PMRT.
CTS5 is an innovative model that could predict the survival benefit of PMRT for T1-2N1 luminal BC patients.
探讨5年后临床治疗评分（CTS5）预测T1-2N1期管腔型乳腺癌（BC）患者乳房切除术后放疗（PMRT）生存获益的临床价值。
将2010年至2015年间诊断为T1-2N1期管腔型BC的患者纳入监测、流行病学和最终结果数据库。采用卡方检验、二项逻辑回归、Kaplan-Meier分析和多变量Cox比例风险模型进行统计分析。
共纳入11190例患者，中位随访时间为76个月。根据CTS5分类，分别有1641例（14.7%）、3915例（35.0%）和5633例（50.3%）患者患有低风险、中风险和高风险疾病。年龄较小、T2期、肿瘤分级较高、阳性淋巴结数量较多、浸润性小叶癌亚型以及接受化疗的患者与接受PMRT相关（所有P<0.05）。多变量分析显示，接受PMRT是与更好的乳腺癌特异性生存（BCSS，P=0.005）和总生存（OS，P<0.001）相关的独立预后因素。敏感性分析显示，与低风险和中风险组未接受PMRT的患者相比，PMRT并未改善BCSS（低风险，P=0.932；中风险，P=0.952）和OS（低风险，P=0.637；中风险，P=0.825）。然而，与未接受PMRT的患者相比，高风险组接受PMRT的患者BCSS（P=0.003）和OS（P<0.001）得到改善。
CTS5是一种创新模型，可预测T1-2N1期管腔型BC患者PMRT的生存获益。
