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乳房切除术、HER2受体阳性、诺丁汉预后指数、晚期和管腔B型肿瘤作为老年乳腺癌患者的不良预后因素

Mastectomy, HER2 Receptor Positivity, NPI, Late Stage and Luminal B-Type Tumor as Poor Prognostic Factors in Geriatric Patients with Breast Cancer.

作者信息

Nak Demet, Kivrak Mehmet

机构信息

Department of Nuclear Medicine, Education and Training Hospital, Recep Tayyip Erdoğan University, 53020 Rize, Turkey.

Department of Biostatistics and Medical Informatics, Division of Basic Medical Sciences, Faculty of Medicine, Recep Tayyip Erdoğan University, 53020 Rize, Turkey.

出版信息

Diagnostics (Basel). 2024 Dec 25;15(1):13. doi: 10.3390/diagnostics15010013.

Abstract

This study aims to explore the risk factors associated with poor survival outcomes in geriatric female patients with breast cancer. This study utilized data from the METABRIC database to evaluate the risk factors associated with poor survival outcomes among geriatric breast cancer patients. A total of 2909 female patients, 766 of whom were geriatric, were included in the study. The effects of the type of surgery; breast cancer types; cellularity; Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status; molecular class; axillary lymph nodes; Nottingham prognostic index (NPI); status of receiving systemic chemotherapy (SCT), hormone therapy (HT), and radiotherapy (RT); tumor size and tumor on overall survival (OS); and progression-free status (PFS) of geriatric patients were investigated. Additionally, the disease-specific survival of geriatric patients was compared with other patients. HER2 receptor positivity, advanced-stage tumors (T3-T4), a high NPI, and Luminal B subtypes were significant predictors of worse outcomes. Conversely, Luminal A tumors, associated with favorable hormonal responsiveness, demonstrated the best progression-free survival (PFS). HER2-positive patients exhibited a poorer PFS compared to their HER2-negative counterparts, underscoring the need for careful management of aggressive subtypes in older adults. Additionally, patients undergoing mastectomy were less likely to receive adjuvant therapies, contributing to inferior outcomes compared to breast-conserving surgery (BCS). Mastectomy, HER2 positivity, high NPI, advanced stages, and Luminal B tumors are significant prognostic factors in geriatric breast cancer patients.

摘要

本研究旨在探讨老年女性乳腺癌患者生存结局不佳的相关危险因素。本研究利用METABRIC数据库的数据来评估老年乳腺癌患者生存结局不佳的相关危险因素。该研究共纳入2909例女性患者,其中766例为老年患者。研究了手术类型、乳腺癌类型、细胞密度、雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(HER2)状态、分子分类、腋窝淋巴结、诺丁汉预后指数(NPI)、接受全身化疗(SCT)、激素治疗(HT)和放疗(RT)的情况、肿瘤大小以及肿瘤对老年患者总生存期(OS)和无进展生存期(PFS)的影响。此外,还比较了老年患者的疾病特异性生存期与其他患者的情况。HER2受体阳性、晚期肿瘤(T3 - T4)、高NPI和Luminal B亚型是预后较差的显著预测因素。相反,具有良好激素反应性的Luminal A肿瘤显示出最佳的无进展生存期(PFS)。HER2阳性患者的PFS比HER2阴性患者差,这突出了对老年侵袭性亚型患者进行谨慎管理的必要性。此外,与保乳手术(BCS)相比,接受乳房切除术的患者接受辅助治疗的可能性较小,导致结局较差。乳房切除术、HER2阳性、高NPI、晚期以及Luminal B肿瘤是老年乳腺癌患者的重要预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5401/11720289/c8f015b38f6a/diagnostics-15-00013-g001.jpg

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