Evaluation of efficacy of chemotherapy for mucinous carcinoma: a surveillance, epidemiology, and end results cohort study.
Evaluation of efficacy of chemotherapy for mucinous carcinoma: a surveillance, epidemiology, and end results cohort study.
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粘液癌化疗疗效评估：监测、流行病学和最终结果队列研究
DOI：
10.1177/1758835920975603
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发表时间：
2020
影响因子：
4.9
通讯作者：
Yang Q
中科院分区：
文献类型：
--
作者：
Zhang H;Zhang N;Li Y;Liang Y;Yang Q
背景资料：在这项研究中，我们使用监测、流行病学和最终结果（SEER）数据库调查了化疗对粘液癌患者乳腺癌特异性生存率（BCSS）的影响。方法：进行了一项基于SEER的大规模回顾性分析;确定了1994年至2014年的13，329例粘液腺癌患者。采用卡方检验比较临床病理特征。使用Kaplan-Meier方法生成BCSS曲线。采用单变量和多变量回归分析计算所有人口统计学和临床病理学特征以及治疗模式的预后意义。结果如下：在Kaplan-Meier分析中，粘液癌的侵袭性低于浸润性导管癌，并且预测预后更好（风险比= 0.336，95%置信区间：0.308-0.368，p < 0.001）。单变量和多变量分析显示，化疗并没有为粘液癌患者提供任何额外的好处。接受化疗的预测因素为年龄较小、雌激素受体阴性、孕激素受体阴性和人表皮生长因子受体2阳性状态、级别较高、肿瘤较大、淋巴结受累、接受放疗和乳房切除术。进一步的亚组分析证实，无论激素受体（HR）和淋巴结（LN）状态如何，患者均未从化疗中获益。结论：我们的研究表明，HR+/LN-粘液癌患者不能从化疗中获益，基于大规模SEER数据，化疗不能改善所有粘液癌亚型的生存率。这些结果支持粘液癌患者可以免于化疗。需要进一步的研究来进一步评估辅助治疗的影响，特别是在组织学良好的患者中。
Background: In this study, we investigated the impact of chemotherapy on breast cancer-specific survival (BCSS) in patients with mucinous carcinoma using the surveillance, epidemiology, and end results (SEER) database. Methods: A large-scale SEER-based retrospective analysis was conducted; 13,329 patients with mucinous carcinoma from 1994 to 2014 were identified. Clinicopathological characteristics were compared using the chi-square test. BCSS curves were generated using the Kaplan–Meier method. The prognostic significance of all demographic and clinicopathological characteristics and treatment patterns were calculated using univariate and multivariate regression analyses. Results: Mucinous carcinoma was demonstrated to be less aggressive than invasive ductal carcinoma and predicted a better prognosis in the Kaplan–Meier analysis (hazard ratios = 0.336, 95% confidence interval: 0.308–0.368, p < 0.001). Univariate and multivariate analyses revealed that chemotherapy did not provide any additional benefit for patients with mucinous carcinoma. Predictors for receiving chemotherapy were younger age, estrogen receptor-negative, progesterone receptor-negative, and human epidermal growth factor receptor 2-positive status, higher grade, larger tumor size, lymph node involvement, radiation reception, and mastectomy. Further subgroup analysis verified that regardless of the hormone receptor (HR) and lymph node (LN) status, patients did not benefit from chemotherapy. Conclusion: Our study showed that patients with HR+/LN– mucinous carcinoma did not benefit from chemotherapy and that chemotherapy could not improve the survival of all subtypes of mucinous carcinoma based on large-scale SEER data. These results support that patients with mucinous carcinoma could be exempt from chemotherapy. Additional research is needed to further evaluate the impact of adjuvant treatments, particularly in patients with favorable histology.
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