Favorable outcome in patients with breast cancer in the presence of pathological response after neoadjuvant endocrine therapy
Favorable outcome in patients with breast cancer in the presence of pathological response after neoadjuvant endocrine therapy
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DOI：
10.1016/j.breast.2007.02.003
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发表时间：
2007-10-01
期刊：
影响因子：
3.9
通讯作者：
Fukutomi, Takashi
中科院分区：
文献类型：
--
作者：
Akashi-Tanaka, Sadako;Omatsu, Mutsuko;Fukutomi, Takashi
新辅助内分泌治疗（NAET）可以扩大可以接受保乳手术治疗的乳腺癌患者数量，并可以预测辅助内分泌治疗的获益。由于没有有效的替代标志物的长期结果已经建立，我们进行了前瞻性试验，以评估病理反应和Ki-67指数后，他莫昔芬或阿那曲唑治疗。研究人群包括患有可手术乳腺肿瘤的绝经后妇女，这些肿瘤均为雌激素和孕激素受体阳性，且大于3 cm。缓解分为病理学缓解（最小缓解或更好）和无缓解。无应答（25.5% vs.应答85.9%，p = 0.002）、腋窝淋巴结阳性（58.4% vs.淋巴结阴性100%，p=0.045）和高治疗前Ki-67指数（41.4% vs.低Ki-67 87.1%，p=0.03）患者与5年无复发生存率差显著相关。无复发生存率的多因素分析表明，病理反应是独立的。因此，病理反应可能是一个有利的预后因素后NAET。(c)2007 Elsevier Ltd.保留所有权利。
Neoadjuvant endocrine therapy (NAET) can expand the number of breast cancer patients who can be treated with breast-conserving surgery and can predict benefit from adjuvant endocrine therapy. Because no validated surrogate markers for long-term outcome have been established, we conducted prospective trials to evaluate pathological response and Ki-67 index following treatment with tamoxifen or anastrozole. The study population included postmenopausal women with operable breast tumors that were both estrogen and progesterone receptor-positive and larger than 3 cm. Response was classified as pathological response (minimal response or better) and non-response. Non-responding (25.5%, vs. response 85.9%, p = 0.002), axillary node-positive (58.4% vs. node negative 100%, p=0.045), and high pretreatment Ki-67 index (41.4% vs. low Ki-67 87.1%, p=0.03) patients were significantly associated with poor 5-year relapse-free survival. Multivariate analysis of relapse-free survival indicated that pathological response was independent. Therefore, pathological response may be a favorable prognostic factor after NAET. (c) 2007 Elsevier Ltd. Alt rights reserved.