Impact of established prognostic factors and molecular subtype in very young breast cancer patients: pooled analysis of four EORTC randomized controlled trials.
Impact of established prognostic factors and molecular subtype in very young breast cancer patients: pooled analysis of four EORTC randomized controlled trials.
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DOI：
10.1186/bcr2908
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发表时间：
2011-06-24
期刊：
影响因子：
--
通讯作者：
van de Vijver MJ
中科院分区：
文献类型：
--
作者：
van der Hage JA;Mieog JS;van de Velde CJ;Putter H;Bartelink H;van de Vijver MJ
诊断时的年轻是乳腺癌预后不良的独立因素。在许多治疗指南中，建议对年轻患者进行辅助化疗，无论肿瘤特征如何。然而，关于年轻乳腺癌患者预后因素的数据有限。本研究的目的是确定在年轻乳腺癌患者的临床和病理预后因素的预后价值。来自四个欧洲癌症研究和治疗组织（EORTC）临床试验的数据被汇总，产生了一个由9，938名早期乳腺癌患者组成的数据集，中位随访时间为11年。对于549名年龄小于40岁的患者，包括341名未接受化疗的淋巴结阴性患者，使用组织微阵列处理石蜡肿瘤块进行免疫组化。应用考克斯比例风险分析评估临床和病理因素与总生存期和无远处转移生存期的关系。对于年轻患者，肿瘤大小（P = 0.01），淋巴结状态（P = 0.006）和分子亚型（P = 0.02）是总生存期的独立预后因素。在淋巴结阴性亚组中，只有分子亚型是总生存期的预后因素（P = 0.02）。年轻淋巴结阴性的管腔型A型肿瘤患者10年随访的总生存率为94%，而基底型肿瘤患者为72%。分子亚型是40岁以下乳腺癌患者的一个强有力的独立预后因素。这些数据支持使用既定的预后因素作为诊断工具，以评估疾病的结果，并计划在年轻乳腺癌患者的系统治疗策略。
Young age at the time of diagnosis of breast cancer is an independent factor of poor prognosis. In many treatment guidelines, the recommendation is to treat young patients with adjuvant chemotherapy regardless of tumor characteristics. However, limited data on prognostic factors are available for young breast cancer patients. The purpose of this study was to determine the prognostic value of established clinical and pathological prognostic factors in young breast cancer patients. Data from four European Organisation for Research and Treatment of Cancer (EORTC) clinical trials were pooled, resulting in a dataset consisting of 9,938 early breast cancer patients with a median follow-up of 11 years. For 549 patients aged less than 40 years at the time of diagnosis, including 341 node negative patients who did not receive chemotherapy, paraffin tumor blocks were processed for immunohistochemistry using a tissue microarray. Cox proportional hazard analysis was applied to assess the association of clinical and pathological factors with overall and distant metastasis free survival. For young patients, tumor size (P = 0.01), nodal status (P = 0.006) and molecular subtype (P = 0.02) were independent prognostic factors for overall survival. In the node negative subgroup, only molecular subtype was a prognostic factor for overall survival (P = 0.02). Young node negative patients bearing luminal A tumors had an overall survival rate of 94% at 10 years' follow-up compared to 72% for patients with basal-type tumors. Molecular subtype is a strong independent prognostic factor in breast cancer patients younger than 40 years of age. These data support the use of established prognostic factors as a diagnostic tool to assess disease outcome and to plan systemic treatment strategies in young breast cancer patients.
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影响因子：
8.4
作者：
van der Hage, JA;van de Velde, CJH;Duchateau, L
通讯作者：
Duchateau, L
影响因子：
45.3
作者：
Choi, DH;Lee, NH;Haffty, BG
通讯作者：
Haffty, BG
影响因子：
50.5
作者：
Cancello, G.;Maisonneuve, P.;Colleoni, M.
通讯作者：
Colleoni, M.
DOI：
10.1016/s0360-3016(99)00158-3
发表时间：
1999-08-01
影响因子：
7
作者：
Elkhuizen, PHM;Voogd, AC;van de Vijver, MJ
通讯作者：
van de Vijver, MJ
影响因子：
3.8
作者：
Mueller-Holzner, E;Fink, V;Marth, C
通讯作者：
Marth, C