乳腺癌手术中的新辅助系统治疗:它总是值得的吗?
Pasquale Losurdo1, Margherita Fezzi2, Fabiola Giudici2
1Breast Unit, Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy - palosurdo@gmail.com.
Minerva surgery
|June 7, 2023
概括
手术前的新辅助全身治疗 (NAT) 改善了乳腺癌患者的生存结果. 在NAT之后达到病理完整反应 (pCR) 与更好的生存率有关,特别是在HER2+和光线B瘤中.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 乳腺癌 (BC) 治疗模式正在发展,越来越多地关注手术前的新辅助全身治疗 (NAT).
- 了解NAT对生存和预后的影响对于优化患者护理至关重要.
研究的目的:
- 为了研究在手术前接受NAT的乳腺癌患者的生存结果.
- 评估NAT在预测患者预后方面的作用.
主要方法:
- 从前性机构数据库对2372名乳腺癌患者的回顾性分析.
- 纳入标准适用于78名在NAT后接受手术的患者.
主要成果:
- 病理完整反应 (pCR) 率因亚型而异:50 luminal-B-HER2+ 的50%,HER2+ 的53%和三阴性 (TN) 乳腺癌的18.5%.
- NAT显著影响了淋巴结状况 (P=0.05).
- 获得PCR的患者的生存率为100%,明显优于没有PCR的患者 (P=0.02). 在NAT之后的瘤分子亚型与3年和5年的整体存活率 (OS) 强烈相关,TN BC显示出最差的预后 (P=0.002).
结论:
- 在NAT之后的保守性手术干预是安全有效的.
- 仔细的患者选择和跨学科的治疗规划对于成功的结果至关重要.
- 在乳腺癌研究中,NAT为识别新的预后预测因子和开发新型治疗剂提供了希望.
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