乳腺癌患者的长期结果和反应预测器 乳腺癌患者的长期结果和反应预测器 乳腺癌患者的长期结果和反应预测器
Journal of the American College of Surgeons
|October 23, 2023
概括
新辅助全身疗法 (NST) 改善了晚期乳腺癌患者的存活率. 在下或乳房实现病理完整反应 (pCR) 显著提高无事件生存率 (EFS).
科学领域:
- 在瘤学瘤学.
- 乳腺癌研究研究 乳腺癌研究
- 临床结果 临床结果
背景情况:
- 乳腺癌中先进的结节疾病历来与预后不佳相关.
- 现代的新辅助系统疗法 (NST) 增加了病理完整反应 (pCR) 率,改善了生存结果.
- 评估晚期结节参与 (cN2-3) 患者的结果以及他们对NST的反应至关重要.
研究的目的:
- 为了评估与NST治疗的cN2-3原发性非转移性乳腺癌患者的当代结果.
- 为了确定对NST (pCR) 的反应与存活率之间的关联.
- 在这个高风险队列中确定无事件生存 (EFS) 的预测因素.
主要方法:
- 对521名cN2-3乳腺癌患者的回顾性分析,这些患者接受了NST,手术和放射治疗 (2012-2018).
- 使用了描述性统计,卡普兰-梅尔生存分析和多变量考克斯回归.
- 关键结果包括和乳腺pCR率,EFS,局部区域复发率和远程转移率.
主要成果:
- 巴pCR的总比率为34.2%,乳房和巴pCR的综合比率为19.4%.
- 五年无事件生存率 (EFS) 为75.1%.
- 实现腹pCR (有或没有乳腺pCR) 和乳腺/腹pCR是显著更长EFS的独立预测因素. 三重阴性疾病与更糟糕的EFS有关.
结论:
- 三种疗法在实现高风险cN2-3乳腺癌患者的持久性EFS方面表现出有效性.
- 大约三分之一的患者获得了下pCR,这一发现与改善的生存率有关.
- 需要进一步的研究来完善NST后的腹反应评估,以指导降级策略和减少外科手术发病率.
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