Chan Patrick Mun Yew, Ong Kay Hsiang, Kuah Sherwin, Sim E Jan, Chen Juliana, Goh Mui Heng, Ang Wei-Wen, Tan Ern Yu
Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore.
Lee Kong Chian School of Medicine, Singapore 308232, Singapore.
Cancers (Basel). 2024 Dec 19;16(24):4228. doi: 10.3390/cancers16244228.
With greater awareness and increased screening, cancers are increasingly being diagnosed at stage I. Women with these small node-negative tumours have excellent survival prospects after surgery, but many women, especially those with triple-negative and human epidermal growth factor receptor (HER)-2-positive tumours, still receive adjuvant systemic treatments to reduce the recurrence risk.
We review the outcomes of women diagnosed with stage I (T1N0M0) tumours in our unit and examine the effect of systemic chemotherapy with/without targeted therapy on recurrence patterns and survival outcomes.
We reviewed 643 women diagnosed with T1N0M0 disease over a 10-year period. Five-year recurrence-free survival (RFS) was 96.6% and the 10-year RFS was 95.5%. Recurrence occurred in 4.7% of the women and was limited to locoregional sites in two-thirds of the instances. Systemic recurrences developed in 12 women, all of whom had ER-positive/HER2-negative disease. The mode of surgery emerged as the only independent predictor of recurrence. Recurrence was highest in women treated with wide local excision (WLE) alone ( < 0.05), but not in those who had received breast radiation after WLE ( = 0.112). Systemic chemotherapy, with or without anti-HER2 therapy, was discussed with 334 women, of whom 50.6% received the treatment; these women were more often younger and had triple-negative or HER2-positive tumours ( < 0.001). Women who received chemotherapy showed a non-significant tendency to develop locoregional recurrence ( = 0.104), but the number of systemic recurrences were similar to those documented in women who had not received chemotherapy. Chemotherapy and/or targeted treatment was not observed to have a significant effect on 5-year recurrence-free survival ( = 0.444).
Stage I cancers have excellent survival outcomes. An optimal local surgical treatment is important and we did not find chemotherapy and/or targeted therapy to produce any significant differences in survival.
随着人们认识的提高和筛查的增加，癌症越来越多地在I期被诊断出来。患有这些小的无淋巴结转移肿瘤的女性在手术后有良好的生存前景，但许多女性，尤其是那些三阴性和人表皮生长因子受体（HER）-2阳性肿瘤的女性，仍接受辅助性全身治疗以降低复发风险。
我们回顾了在我们科室被诊断为I期（T1N0M0）肿瘤的女性的治疗结果，并研究了全身化疗联合或不联合靶向治疗对复发模式和生存结果的影响。
我们回顾了10年间643例被诊断为T1N0M0疾病的女性。5年无复发生存率（RFS）为96.6%，10年RFS为95.5%。4.7%的女性出现复发，其中三分之二局限于局部区域。12名女性发生全身复发，她们均为雌激素受体（ER）阳性/HER2阴性疾病。手术方式是复发的唯一独立预测因素。仅接受局部广泛切除（WLE）的女性复发率最高（<0.05），但接受WLE后进行乳腺放疗的女性复发率无差异（=0.112）。334名女性讨论了全身化疗联合或不联合抗HER2治疗，其中50.6%接受了治疗；这些女性更年轻，且多为三阴性或HER2阳性肿瘤（<0.001）。接受化疗的女性出现局部区域复发的趋势不显著（=0.104），但全身复发的数量与未接受化疗的女性相似。未观察到化疗和/或靶向治疗对5年无复发生存率有显著影响（=0.444）。
I期癌症有良好的生存结果。最佳的局部手术治疗很重要，我们未发现化疗和/或靶向治疗在生存方面有任何显著差异。
