Prognostic factors for survival after neoadjuvant chemotherapy in operable breast cancer:: the role of clinical response
Prognostic factors for survival after neoadjuvant chemotherapy in operable breast cancer:: the role of clinical response
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DOI：
10.1016/s0959-8049(03)00069-8
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发表时间：
2003-05-01
影响因子：
8.4
通讯作者：
Pouillart, P
中科院分区：
文献类型：
--
作者：
Pierga, JY;Mouret, E;Pouillart, P
这项回顾性研究的目的是评估术前化疗临床反应的预测因素和生存的预后因素。 1981年至1992年，从居里研究所数据库中选取了936例接受2-6个月（中位4个月）术前化疗的T2-T3、N0-N1乳腺癌患者。术前治疗之后进行手术和/或放射治疗。中位随访时间为 8.5 年（范围 7-211 个月）。手术和/或放疗前的客观缓解率为58.3%。在逐步多变量分析（Cox模型）中，生存的有利预后因素是没有病理性腋窝淋巴结受累（相对风险（RR）1.54；P=0.0004）、低组织学肿瘤分级（RR=1.54 P=0.0017）、对术前化疗的临床反应（RR=1.45，P=0.0013）、孕激素受体（PR）状态阳性（RR=1.56：P=0.0001），肿瘤体积较小（RR=1.37；P=0.005）并且缺乏临床淋巴结受累（RR=1.42：P=0.007）。临床肿瘤反应与生存的关联独立于肿瘤的基线特征。在评估病理反应之前，临床反应可以作为评估新辅助化疗疗效的替代指标。 (C) 2003 Elsevier Science Ltd. 保留所有权利。
The aim of this retrospective study was to assess predictive factors for clinical response to preoperative chemotherapy and prognostic factors for survival. From 1981 to 1992, 936 patients with T2-T3, N0-N1 breast cancer who received 2-6 months (median 4) of preoperative chemotherapy were selected from the Institute Curie database. Preoperative treatment was followed by surgery and/or radiotherapy. Median follow-up was 8.5 years (range 7-211 months). The objective response rate before surgery and/or radiotherapy was 58.3%. In stepwise multivariate analysis (Cox model), favourable prognostic factors for survival were the absence of pathological axillary lymph node involvement (Relative Risk (RR) 1.54; P=0.0004), low histological tumour grade (RR=1.54 P=0.0017), clinical response to preoperative chemotherapy (RR=1.45, P=0.0013), positive progesterone receptor (PR) status (RR=1.56: P=0.0001), smaller tumour size (RR=1.37; P=0.005) and lack of clinical lymph node involvement (RR=1.42: P=0.007). The association of clinical tumour response with survival is independent of the baseline characteristics of the tumour. Clinical response could be used as a surrogate marker for evaluation of the efficacy of neoadjuvant chemotherapy before assessment of the pathological response. (C) 2003 Elsevier Science Ltd. All rights reserved.