Residual risk of breast cancer recurrence 5 years after adjuvant therapy
Residual risk of breast cancer recurrence 5 years after adjuvant therapy
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DOI：
10.1093/jnci/djn233
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发表时间：
2008-08-20
影响因子：
10.3
通讯作者：
Esteva, Francisco J.
中科院分区：
文献类型：
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作者：
Brewster, Abenaa M.;Hortobagyi, Gabriel N.;Esteva, Francisco J.
有有限的预后信息来确定乳腺癌患者在辅助或新辅助系统治疗(AST)后有晚期复发的风险。我们对1985年1月1日至2001年11月1日期间接受AST治疗的2838例I-III期乳腺癌患者的复发残余风险和预后因素进行了评估，这些患者5年内没有复发。采用Kaplan-Meier方法评估术后5年至首次复发或最后一次随访的剩余无复发生存率。组间比较采用对数等级检验(双侧)。5年和10年的无复发生存率分别为89%和80%，216例患者发生复发事件。I、II、III期癌症患者的5年复发剩余风险分别为7%(95%可信区间=3%~15%)、11%(95%CI=9%~13%)和13%(95%CI=10%~17%)(P=0.02)。在多变量分析中，分期、分级、激素受体状态和内分泌治疗与晚期复发相关。乳腺癌患者有相当大的残留复发风险，而选定的肿瘤特征与晚期复发有关。
There is limited prognostic information to identify breast cancer patients who are at risk for late recurrences after adjuvant or neoadjuvant systemic therapy (AST). We evaluated the residual risk of recurrence and prognostic factors of 2838 patients with stage I-III breast cancer who were treated with AST between January 1, 1985, and November 1, 2001, and remained disease free for 5 years. Residual recurrence-free survival was estimated from the landmark of 5 years after AST to date of first recurrence or last follow-up using the Kaplan-Meier method. The log-rank test (two-sided) was used to compare groups. Residual recurrence-free survival rates at 5 and 10 years were 89% and 80%, respectively, and 216 patients developed a recurrence event. The 5-year residual risks of recurrence for patients with stage I, II, and III cancers were 7% (95% confidence interval [CI] = 3% to 15%), 11% (95% Cl = 9% to 13%), and 13% (95% Cl = 10% to 17%), respectively (P =.02). In multivariable analysis, stage, grade, hormone receptor status, and endocrine therapy were associated with late recurrences. Breast cancer patients have a substantial residual risk of recurrence, and selected tumor characteristics are associated with late recurrences.