Long-term outcome of neoadjuvant systemic therapy for locally advanced breast cancer in routine clinical practice.
Long-term outcome of neoadjuvant systemic therapy for locally advanced breast cancer in routine clinical practice.
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DOI：
10.1007/s00432-012-1325-9
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发表时间：
2013-02
影响因子：
3.6
通讯作者：
Natoli, Clara
中科院分区：
文献类型：
--
作者：
Angelucci, Domenico;Tinari, Nicola;Grassadonia, Antonino;Cianchetti, Ettore;Ausili-Cefaro, Giampiero;Iezzi, Laura;Zilli, Marinella;Grossi, Simona;Ursini, Lucia Anna;Scognamiglio, Maria Teresa;Castrilli, Graziella;De Tursi, Michele;Noccioli, Paolo;Cioy, Pasquale;Iacobelli, Stefano;Natoli, Clara
关键词：
本研究的目的是评估局部晚期乳腺癌患者在常规临床实践中接受新辅助全身化疗（NST）的长期预后。1999年1月至2011年12月期间发现了490例患者。所有患者均接受NST治疗，随后进行手术、辅助治疗和放疗。Kaplan-Meier分析显示，手术III期患者更有可能发生远处转移并死于乳腺癌（p < 0.001）。Luminal A和Luminal B/ her2阴性患者预后较好；此外，激素受体（HR）阳性肿瘤患者的DRFS （p < 0.0049）和OS （p < 0.0001）明显长于HR阴性肿瘤患者和行保乳手术的患者（DRFS和OS: p < 0.001）。在多因素分析中，HR阴性（DRFS和OS均p < 0.001）、乳房切除术（DRFS: p = 0.009; OS: p = 0.05）和III期疾病（DRFS: p < 0.001; OS: p = 0.003）与较短的DRFS和OS相关。HR阴性、乳房切除术和病理性III期疾病是与我们患者队列中较差结果独立相关的变量。这些数据非常有趣，因为它们来自一组非常不同的患者，在临床试验之外接受不同的新辅助/辅助方案治疗，随访时间很长。
The aim of this study is to evaluate the long-term outcome of patients with locally advanced breast cancer treated with neoadjuvant systemic chemotherapy (NST) in routine clinical practice. Four hundred and nine patients were identified between January 1999 and December 2011. All patients received NST followed by surgery, adjuvant treatments and radiotherapy, as appropriate. At Kaplan–Meier analysis, patients with surgical stage III disease were more likely to develop distant metastasis and die from breast cancer (p < 0.001). Luminal A and luminal B/HER2-negative patients had better prognosis; moreover, patients with hormone receptor (HR)-positive tumors had a significantly longer DRFS (p < 0.0049) and OS (p < 0.0001) compared with patients with HR-negative tumors as well as patients who underwent breast-conserving surgery (DRFS and OS: p < 0.001). In multivariate analysis, HR negativity (p < 0.001 for both DRFS and OS), mastectomy (DRFS: p = 0.009; OS: p = 0.05) and stage III disease (DRFS: p < 0.001; OS: p = 0.003) were associated with shorter DRFS and OS. HR negativity, mastectomy and pathological stage III disease are the variables independently associated with a worse outcome in our cohort of patients. These data are of high interest since they derive from a very heterogeneous group of patients, treated with different neoadjuvant/adjuvant regimens outside of clinical trials and with a long follow-up period.
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影响因子：
9
作者：
Cance, WG;Carey, LA;Graham, M
通讯作者：
Graham, M
影响因子：
3.5
作者：
El-Din, Mohamed A. Alm;Taghian, Alphonse G.
通讯作者：
Taghian, Alphonse G.
影响因子：
168.9
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Albain, K.;Anderson, S.;Arriagada, R.;Barlow, W.;Bergh, J.;Bliss, J.;Buyse, M.;Cameron, D.;Carrasco, E.;Clarke, M.;Correa, C.;Coates, A.;Collins, R.;Costantino, J.;Cutter, D.;Cuzick, J.;Darby, S.;Davidson, N.;Davies, C.;Davies, K.;Delmestri, A.;Di Leo, A.;Dowsett, M.;Elphinstone, P.;Evans, V.;Ewertz, M.;Gelber, R.;Gettins, L.;Geyer, C.;Goldhirsch, A.;Godwin, J.;Gray, R.;Gregory, C.;Hayes, D.;Hill, C.;Ingle, J.;Jakesz, R.;James, S.;Kaufmann, M.;Kerr, A.;MacKinnon, E.;McGale, P.;McHugh, T.;Norton, L.;Ohashi, Y.;Paik, S.;Pan, H. C.;Perez, E.;Peto, R.;Piccart, M.;Pierce, L.;Pritchard, K.;Pruneri, G.;Raina, V.;Ravdin, P.;Robertson, J.;Rutgers, E.;Shao, Y. F.;Swain, S.;Taylor, C.;Valagussa, P.;Viale, G.;Whelan, T.;Winer, E.;Wang, Y.;Wood, W.
通讯作者：
Wood, W.
影响因子：
8.4
作者：
Houssami, Nehmat;Macaskill, Petra;Mamounas, Eleftherios
通讯作者：
Mamounas, Eleftherios
影响因子：
45.3
作者：
Green, MC;Buzdar, AU;Hortobagyi, GN
通讯作者：
Hortobagyi, GN