Lo Chiao, Chang Dwan-Ying, Lu Yen-Shen, Wang Ming-Yang, Tsai Li-Wei, Huang Chiun-Sheng, Tang Chao-Hsiun, Lin Ching-Hung
Department of Surgery, National Taiwan University Hospital, Taipei 100225, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100229, Taiwan.
Oncologist. 2025 Feb 6;30(2). doi: 10.1093/oncolo/oyae346.
The efficacy of adjuvant chemotherapy for T1N0M0 triple-negative breast cancer (TNBC) has not been clearly elucidated. Thus, we aimed to evaluate the efficacy of adjuvant chemotherapy for patients with T1a-cN0M0 TNBC.
Patients newly diagnosed with TNBC between 2011 and 2015 were identified and followed up until the end of 2020 using the Taiwan Cancer Registry. Univariate and multivariate Cox proportional hazards regression analyses were performed to compare the recurrence-free survival (RFS) and OS between patients who received and those who did not receive adjuvant chemotherapy.
Of the 62 483 patients registered during 2011-2015, 1074 patients with T1N0M0 TNBC (T1a, n = 103; T1b, n = 167; and T1c, n = 804) who underwent definitive breast surgery were included. Overall, 850 (79%) patients received adjuvant chemotherapy; these comprised 24.3%, 67.7%, and 88.6% of the patients with T1a, T1b, and T1c disease, respectively. Over a median follow-up of 7.18 years, a significant RFS and OS benefit from adjuvant chemotherapy was observed in the T1c subgroup but not in the T1a and T1b subgroups. However, subgroup analysis of T1b disease indicated that adjuvant chemotherapy yielded an OS benefit to patients with histological grade III disease (adjusted hazard ratio = 0.08, 95% CI, 0.01-0.77; P = .03).
Adjuvant chemotherapy improved the RFS and OS in patients with T1cN0M0 TNBC and improved the OS in patients with histological grade III T1bN0M0 disease. Our study advocates for the utilization of adjuvant chemotherapy in patients diagnosed with T1cN0M0 and histological grade III T1bN0M0 TNBC.
辅助化疗对T1N0M0三阴性乳腺癌（TNBC）的疗效尚未明确阐明。因此，我们旨在评估辅助化疗对T1a - cN0M0 TNBC患者的疗效。
利用台湾癌症登记处确定2011年至2015年间新诊断为TNBC的患者，并随访至2020年底。进行单因素和多因素Cox比例风险回归分析，以比较接受和未接受辅助化疗患者的无复发生存期（RFS）和总生存期（OS）。
在2011 - 2015年登记的62483例患者中，纳入了1074例行根治性乳房手术的T1N0M0 TNBC患者（T1a，n = 103；T1b，n = 167；T1c，n = 804）。总体而言，850例（79%）患者接受了辅助化疗；这些患者分别占T1a、T1b和T1c疾病患者的24.3%、67.7%和88.6%。在中位随访7.18年期间，T1c亚组中观察到辅助化疗对RFS和OS有显著益处，而T1a和T1b亚组则未观察到。然而，T1b疾病的亚组分析表明，辅助化疗对组织学III级疾病患者的OS有益（调整后风险比 = 0.08，95% CI，0.01 - 0.77；P = 0.03）。
辅助化疗改善了T1cN0M0 TNBC患者的RFS和OS，并改善了组织学III级T1bN0M0疾病患者的OS。我们的研究主张对诊断为T1cN0M0和组织学III级T1bN0M0 TNBC的患者使用辅助化疗。
