优化不可手术的局部晚期乳腺癌的治疗顺序:手术的长期结果首先与新辅助化疗在现实世界中设置
Bowen Liu1, Yu Song1, Ying Xu1
1Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
International journal of cancer
|August 23, 2024
概括
前置手术是局部晚期乳腺癌 (LABC) 的可行选择,特别是对于年轻患者或IIIA阶段疾病患者. 新辅助化疗 (NAC) 反应对于预测LABC患者的结果至关重要.
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:
- 局部晚期乳腺癌 (LABC) 提出了治疗挑战.
- 关于长期结果的有限数据存在,比较现实世界LABC队列中的前期手术与新辅助化疗 (NAC).
研究的目的:
- 调查前期手术的可行性和长期生存结果,与不可操作的LABC的NAC相比.
- 为了确定可能从前端手术中获益更多的患者子组.
主要方法:
- 对243名不可手术的LABC患者 (不包括T3N1M0) 的回顾性分析.
- 前置手术 (n=187) 与NAC (n=56) 组之间的比较.
- 卡普兰-梅尔总生存率 (OS) 和无病生存率 (DFS) 的生存分析,用于小组分析的Cox比例危险模型.
主要成果:
- 在前期手术和NAC组之间,在5年的OS (89.6%与81.9%) 或DFS (73.0%与67.1%) 中没有显著差异.
- 前部手术显示,60岁以下和IIIA阶段疾病的患者的生存状况明显改善.
- 对NAC (进展或稳定的疾病) 的反应不佳与明显更糟糕的DFS和OS有关.
结论:
- 前部手术是选择LABC患者的可行和潜在有益的治疗策略.
- 患者的年龄,特定瘤阶段 (IIIA) 和瘤大小可能会影响治疗选择.
- NAC反应是一个关键的预后因素,为LABC提供了个性化治疗策略.
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