Determining prognostic factors and optimal surgical intervention for early-onset triple-negative breast cancer.
Determining prognostic factors and optimal surgical intervention for early-onset triple-negative breast cancer.
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确定早发三阴性乳腺癌的预后因素和最佳手术干预
DOI：
10.3389/fonc.2022.910765
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发表时间：
2022
影响因子：
4.7
通讯作者：
Xie, Ni
中科院分区：
文献类型：
--
作者：
Zheng, Yi-Zi;Liu, Yan;Deng, Zhen-Han;Liu, Guo-Wen;Xie, Ni
关键词：
很少有研究专门关注早发性三阴性乳腺癌（eTNBC）的预后因素和最佳手术干预，其特征是恶性程度高，预后差。方法我们进行了一项队列研究，中位随访时间为31个月，使用2010年至2016年期间诊断为I-III期eTNBC患者的监测，流行病学和最终结果（SEER）数据。此外，我们从我们的中心收集了2006年至2016年之间的病例作为外部验证集。分析其临床特征、病理学特征及肿瘤学转归。通过考克斯比例风险分析确定总生存期（OS）和乳腺癌特异性生存期（BCSS）的预后因素，并将其纳入预后列线图。进行基于倾向评分匹配方法的亚组分析，以探索将从保乳治疗（BCT）中获益的患者亚组。结果基于SEER数据集，eTNBC患者比BCT患者更可能接受乳房切除术。在多变量分析中，具有较好生存结局的患者是那些未婚、无保险、T和N分期较高、组织学类型为浸润性导管和小叶混合癌的患者。基于这些变量的预后列线图成功预测了3年和5年BCSS（训练队列中的C指数为0.774; SEER验证队列中的C指数为0.768;我们中心验证队列中的C指数为0.723）。亚组分析表明，T1 N 0 M0或T2- 4 N +M0肿瘤患者接受BCT的总生存期长于接受乳房切除术的患者（对于T1 N 0 M0，P = 0.022;对于T2- 4 N +M0，P = 0.003）;然而，手术类型不影响T1 N +M0或T2- 4 N 0 M0肿瘤患者的OS（T1N+M0，P = 0.305; T2-4N0M0，P = 0.317）。结论eTNBC患者的预后主要受婚姻状况、保险状况、T分期、N分期及组织学类型的影响。基于这些因素的预测诺模图是相当可靠的。亚组分析表明，BCT可能是eTNBC患者的上级选择，尤其是T1 N 0 M0和T2- 4 N +M0肿瘤患者。
Background Few studies have focused specifically on prognostic factors and optimal surgical intervention for early-onset triple-negative breast cancer (eTNBC), which is characterized by high malignancy and poor prognosis. Methods We performed a cohort study with a median follow-up of 31 months using Surveillance, Epidemiology, and End Results (SEER) data of patients diagnosed with stages I–III eTNBC between 2010 and 2016. In addition, we collected cases between 2006 and 2016 from our center as an external validation set. Clinical features, pathologic characteristics and oncologic outcomes were analyzed. Prognostic factors for overall survival (OS) and breast cancer-specific survival (BCSS) were determined by Cox proportional hazards analyses and were incorporated into the prognostic nomogram. Subgroup analysis based on propensity score matching method was conducted to explore the subset of patients that would benefit from breast-conserving therapy (BCT). Results Based on SEER dataset, patients with eTNBC were more likely to undergo mastectomy than BCT. On multivariable analysis, patients with better survival outcomes were those not married, uninsured, had higher T and N stage, and had histological type of mixed invasive ductal and lobular carcinoma. The prognostic nomogram based on these variables successfully predicted the 3- and 5-year BCSS (C-index in training cohort, 0.774; in validation cohort from SEER, 0.768; in validation cohort from our center, 0.723). Subgroup analysis illustrated that patients with T1N0M0 or T2-4N+M0 tumors who underwent BCT achieved longer overall survival than those who underwent mastectomy (for T1N0M0, P = 0.022; for T2-4N+M0, P = 0.003); however, the type of surgery did not influence OS among patients with T1N+M0 or T2-4N0M0 tumors (for T1N+M0, P = 0.305; for T2-4N0M0, P = 0.317). Conclusions The prognosis of patients with eTNBC is mainly affected by marital status, insurance status, T stage, N stage and histological type. The prognostic nomogram based on these factors is quite reliable. Subgroup analysis suggested that BCT may be a superior option for patients with eTNBC, especially those with T1N0M0 and T2-4N+M0 tumors.
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影响因子：
3.2
作者：
Johnson RH;Anders CK;Litton JK;Ruddy KJ;Bleyer A
通讯作者：
Bleyer A
影响因子：
6.2
作者：
Lund, Mary Jo;Butler, Ebonee N.;Eley, J. William
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影响因子：
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作者：
Del Turco, M. Rosselli;Ponti, A.;Cataliotti, L.
通讯作者：
Cataliotti, L.
DOI：
10.1016/s1470-2045(17)30891-4
发表时间：
2018-03
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Copson ER;Maishman TC;Tapper WJ;Cutress RI;Greville-Heygate S;Altman DG;Eccles B;Gerty S;Durcan LT;Jones L;Evans DG;Thompson AM;Pharoah P;Easton DF;Dunning AM;Hanby A;Lakhani S;Eeles R;Gilbert FJ;Hamed H;Hodgson S;Simmonds P;Stanton L;Eccles DM
通讯作者：
Eccles DM
影响因子：
9.3
作者：
Hjorth CF;Damkier P;Ejlertsen B;Lash T;Sørensen HT;Cronin-Fenton D
通讯作者：
Cronin-Fenton D