Factors predicting late recurrence for estrogen receptor-positive breast cancer.
Factors predicting late recurrence for estrogen receptor-positive breast cancer.
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DOI：
10.1093/jnci/djt244
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发表时间：
2013-10-02
期刊：
影响因子：
--
通讯作者：
Cuzick J
中科院分区：
文献类型：
--
作者：
Sestak I;Dowsett M;Zabaglo L;Lopez-Knowles E;Ferree S;Cowens JW;Cuzick J
雌激素受体阳性乳腺癌患者辅助内分泌治疗超过5年可降低复发率我们之前已经表明，免疫组织化学标记物（IHC 4）和两种基因表达谱测试（复发评分[RS]和PAM 50复发风险[ROR]）与远端复发时间相关，我们现在已经评估了这些评分和常规临床变量的价值，特别是在5至10年的预测结果。我们使用单变量和多变量比例风险模型来确定所有变量和评分（IHC 4，RS，ROR）对所有患者远端复发的预后价值，分别在0至5年，特别是5至10年。所有统计学检验均为双侧检验。5 - 10年的淋巴结状态和肿瘤大小至少与0 - 5年一样强（淋巴结状态，5-10年：χ2 = 21.72 vs 0-5年：χ2 = 11.08，均P <0.001;肿瘤大小，5-10年：χ2 = 10.52 vs 0-5年：χ2 = 10.82，均P = 0.001）。Ki 67和总体IHC 4评分是5 - 10年期间唯一统计学显著的与远端复发单变量相关的生物标志物（分别为χ2 = 8.67，χ2 = 13.22）。ROR评分是晚期随访期最强的分子预后因子（χ2 = 16.29; P < .001），而IHC 4（χ2 = 7.41）和RS（χ2 = 5.55）在此期间仅是弱预后因子。在所有亚组和所有复发患者中观察到相似的结果。除了淋巴结状态和肿瘤大小外，在第5 - 10年，没有一种IHC 4标志物提供统计学显著的预后信息。ROR在5 - 10年提供了最强的预后信息。这些结果可能有助于选择在5年治疗后从激素治疗中获益最多的患者。
Adjuvant endocrine therapy beyond 5 years reduces recurrence in patients with estrogen receptor–positive breast cancer. We have previously shown that immunohistochemical markers (IHC4) and two gene expression profile tests (recurrence score [RS] and PAM50 risk of recurrence [ROR]) are associated with time to distant recurrence, and we have now assessed the value of each of these scores and routine clinical variables for predicting outcome, specifically in years 5 to 10. We used univariate and multivariable proportional hazards models to determine the prognostic value of all variables and scores (IHC4, RS, ROR) for distant recurrence, separately in years 0 to 5 and specifically for years 5 to 10 for all patients. All statistical tests were two-sided. Nodal status and tumor size were at least as strong in years 5 to 10 as in years 0 to 5 (nodal status, years 5–10: χ2 = 21.72 vs years 0–5: χ2 = 11.08, both P < .001; tumor size, years 5–10: χ2 = 10.52 vs years 0–5: χ2 = 10.82, both P = .001). Ki67 and the overall IHC4 score were the only statistically significant biomarkers related to distant recurrence univariablely in the 5 to 10 year period (χ2 = 8.67, χ2 = 13.22, respectively). The ROR score was the strongest molecular prognostic factor in the late follow-up period (χ2 = 16.29; P < .001), whereas IHC4 (χ2 = 7.41) and RS (χ2 = 5.55) were only weakly prognostic in this period. Similar results were seen for all subgroups and for all recurrences. None of the IHC4 markers provided statistically significant prognostic information in years 5 to 10, except for nodal status and tumor size. ROR gave the strongest prognostic information in years 5 to 10. These results may help select patients who could benefit most from hormonal therapy beyond 5 years of treatment.
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影响因子：
168.9
作者：
Davies, Christina;Pan, Hongchao;Godwin, Jon;Gray, Richard;Arriagada, Rodrigo;Raina, Vinod;Abraham, Mirta;Medeiros Alencar, Victor Hugo;Badran, Atef;Bonfill, Xavier;Bradbury, Joan;Clarke, Michael;Collins, Rory;Davis, Susan R.;Delmestri, Antonella;Forbes, John F.;Haddad, Peiman;Hou, Ming-Feng;Inbar, Moshe;Khaled, Hussein;Kielanowska, Joanna;Kwan, Wing-Hong;Mathew, Beela S.;Mittra, Indraneel;Mueller, Bettina;Nicolucci, Antonio;Peralta, Octavio;Pernas, Fany;Petruzelka, Lubos;Pienkowski, Tadeusz;Radhika, Ramachandran;Rajan, Balakrishnan;Rubach, Maryna T.;Tort, Sera;Urrutia, Gerard;Valentini, Miriam;Wang, Yaochen;Peto, Richard
通讯作者：
Peto, Richard
影响因子：
3.8
作者：
Esserman, Laura J.;Moore, Dan H.;Tsing, Pamela J.;Chu, Philip W.;Yau, Christina;Ozanne, Elissa;Chung, Robert E.;Tandon, Vickram J.;Park, John W.;Baehner, Frederick L.;Kreps, Stig;Tutt, Andrew N. J.;Gillett, Cheryl E.;Benz, Christopher C.
通讯作者：
Benz, Christopher C.
影响因子：
10.3
作者：
Brewster, Abenaa M.;Hortobagyi, Gabriel N.;Esteva, Francisco J.
通讯作者：
Esteva, Francisco J.
影响因子：
168.9
作者：
Davies, C.;Godwin, J.;Gray, R.;Clarke, M.;Darby, S.;McGale, P.;Wang, Y. C.;Peto, R.;Pan, H. C.;Cutter, D.;Taylor, C.;Ingle, J.
通讯作者：
Ingle, J.
影响因子：
51.1
作者：
Williams, Norman
通讯作者：
Williams, Norman