乳腺癌患者在经过新辅助化疗后实现病理完整反应的远程复发的临床病理预测因素
Asako Yamamoto1, Mariko Asaoka1, Yoshiya Horimoto1
1Department of Breast Oncology and Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
概括
乳腺癌患者在新辅助化疗后获得病理完整反应的长期结果是有利的. 然而,治疗前的淋巴结干扰仍然是远程转移的危险因素,特别是在大脑.
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:
- 乳腺癌新辅助化疗 (NAC) 后的病理完整反应 (pCR) 表明预后有利.
- 关于患者实现pCR的长期结果和复发预测因素的数据有限.
- 了解长期复发模式对于优化患者随访至关重要.
研究的目的:
- 评估乳腺癌患者的长期远程无转移存活率 (DMFS),这些患者在NAC后获得了pCR.
- 在这个患者队列中确定远程复发的预测因子.
- 描述远程转移的模式,包括常见的部位和亚型.
主要方法:
- 对365名原发性乳腺癌患者的多中心队列的回顾性分析,这些患者在NAC后实现了pCR.
- 随访时间延长,中位数为96个月.
- 卡普兰-梅尔方法用于生存估计和单变Cox模型用于因子关联分析.
主要成果:
- 10年DMFS和整体存活率高,分别为94.6%和95.2%.
- 远程转移发生在5.5%的患者中,大脑是所有亚型中最常见的部位.
- 在单变量分析中,治疗前临床淋巴结参与是远程转移的显著预测因素.
结论:
- 在NAC后实现pCR与乳腺癌的长期结果普遍有利.
- 治疗前临床淋巴结状况仍然是远期复发的关键风险因素.
- 大脑转移的高发病率值得在实现pCR的患者的长期监测策略中考虑.
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