Impact of wait time from neoadjuvant chemotherapy to surgery in breast cancer: Does time to surgery affect patient outcomes? Time from Neoadjuvant Chemotherapy to Surgery
Impact of wait time from neoadjuvant chemotherapy to surgery in breast cancer: Does time to surgery affect patient outcomes? Time from Neoadjuvant Chemotherapy to Surgery
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DOI：
10.1007/s10549-020-05894-x
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发表时间：
2020-10-01
影响因子：
3.8
通讯作者：
Simmons, Christine
中科院分区：
文献类型：
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作者：
Lai, Valerie;Hajjaj, Omar;Simmons, Christine
目的乳腺癌患者从新辅助化疗(NAC)到手术的最佳时间间隔尚未确定。我们调查了不同的时间间隔是否影响该人群的病理完全缓解率(PCR)、无病存活率(DFS)、总存活率(OS)、手术并发症以及从乳房切除到保乳手术(BCS)的中转率。方法我们确定了2012年5月至2018年4月在不列颠哥伦比亚省癌症机构接受NAC并随后进行手术的患者。患者根据NAC和手术之间的时间间隔进行分组：<；4周、4-8周和>；8周。采用Kaplan Meier方法估计DFS和OS。还比较了不同时间间隔之间的聚合酶链式反应比率。结果343例患者中78例(22.8%)在NAC后4周接受手术治疗，233例(67.9%)在NAC后4-8周接受手术治疗，32例(9.3%)在NAC后8周接受手术治疗，中位手术时间(TTS)为5.0周。PCR率分别为32.1%、32.2%和28.1%(P=0.90)。中位随访时间为3.3年。5年DFS分别为76%、78%和70%(p=0.89)。5年生存率分别为83%、82%和78%(p=0.33)。两组的手术并发症(p=0.90)或中转率(p=0.19)差异无统计学意义。结论在末次给药后4周、4-8周或8周接受手术治疗的乳腺癌患者的PCR值、DFS、OS、手术并发症和从乳房切除到BCS的中转率没有统计学意义上的差异。
Purpose The optimal time interval from neoadjuvant chemotherapy (NAC) to surgery in patients with breast cancer has not been established. We investigated whether different time intervals impact the rate of pathologic complete response (pCR), disease free survival (DFS), overall survival (OS), surgical complications, and rates of conversion from mastectomy to breast conserving surgery (BCS) in this population. Methods We identified patients who received NAC at the BC Cancer Agency followed by surgery from May 2012 to April 2018. Patients were grouped based on time interval between NAC and surgery: < 4 weeks, 4-8 weeks, and > 8 weeks. Kaplan Meier method was used to estimate DFS and OS. Rates of pCR between the time intervals were also compared. Results Of the 343 patients, 78 (22.8%) received surgery < 4 weeks, 233 (67.9%) received surgery between 4-8 weeks, and 32 (9.3%) received surgery > 8 weeks after NAC, with a median time to surgery (TTS) of 5.0 weeks. pCR was observed in 32.1%, 32.2%, and 28.1%, respectively (p = 0.90). Median follow-up time was 3.3 years. The 5-year DFS was 76%, 78%, and 70% (p = 0.89), respectively. The 5-year OS was 83%, 82%, and 78% (p = 0.33), respectively. No statistically significant differences were seen in surgical complications (p = 0.90), or rates of conversion from mastectomy to BCS (p = 0.19). Conclusions There were no statistically significant differences in pCR, DFS, OS, surgical complications, and rates of conversion from mastectomy to BCS, among breast cancer patients receiving surgery < 4 weeks, 4-8 weeks, or > 8 weeks after the last dose of NAC.