Estrogen receptors and distinct patterns of breast cancer relapse
Estrogen receptors and distinct patterns of breast cancer relapse
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DOI：
10.1023/a:1022166517963
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发表时间：
2003-03-01
影响因子：
3.8
通讯作者：
Hortobagyi, GN
中科院分区：
文献类型：
--
作者：
Hess, KR;Pusztai, L;Hortobagyi, GN
背景我们对前瞻性收集的数据进行了分析，以比较ER阴性与ER阳性肿瘤在复发率和复发部位方面的临床表现。在1980年至1986年期间，共有647例可手术II期或III期乳腺癌患者参加了两个连续的辅助治疗方案。对558例（86%）有ER状态数据的乳腺癌患者，采用风险函数和风险比函数分析ER状态与首次复发时间、首次复发部位和死亡时间的相关性。在随访的前两年，ER阴性患者的复发率显著较高，但此后则无此现象。在乳腺癌死亡方面也观察到了类似的结果，这些结果在调整了治疗、年龄、绝经状态和肿瘤负荷的差异后仍然有效。当研究首次复发部位时，ER阴性状态与内脏和软组织肿瘤复发率显著较高相关，而ER阳性状态与累及骨的肿瘤复发率显著较高相关。ER阳性肿瘤的临床表现不同于ER阴性肿瘤。ER状态对复发率和复发部位有显著影响。此外，这种明显的相关性在随访期间减弱。在随访的前两年，ER阴性患者的复发率显著较高，但此后则无此现象。
Background. We conducted an analysis of prospectively collected data to compare the clinical behavior of ER-negative versus ER-positive tumors with respect to rates and sites of recurrence.Methods. A total of 647 patients with operable stage II or III breast cancer were enrolled in two consecutive adjuvant therapy protocols conducted between 1980 and 1986. The correlations between ER status and time to first recurrence, site of first recurrence, and time to breast cancer death were assessed on 558 (86%) patients with available ER status data using hazard function and hazard ratio function analysis.Results. The rates of recurrence were significantly higher in patients with ER-negative status for the first two years of follow-up, but not thereafter. Similar results were observed for breast cancer death, and these results held up after adjustment for differences in treatment, age, menopausal status, and tumor burden. When the site of first recurrence was studied, ER-negative status was associated with a significantly higher rate of tumor recurrence in the viscera and soft tissues, while ER-positive status was associated with significantly higher rates of tumor recurrence involving bone.Conclusions. The clinical behavior of ER-positive tumors is different from ER-negative cancer. ER status had a pronounced effect on the rates and sites of recurrence. Furthermore, this apparent association diminished over the follow-up period. Recurrence rates were significantly higher in patients with ER-negative status for the first two years of follow-up, but not thereafter.