Impact of age on pathological complete response and locoregional recurrence in locally advanced breast cancer after neoadjuvant chemotherapy

被引:34
|
作者
Chou, Hsu-Huan [1 ]
Kuo, Wen-Ling [1 ]
Yu, Chi-Chang [1 ]
Tsai, Hsiu-Pei [1 ]
Shen, Shih-Cheh [1 ]
Chu, Chia-Hui [1 ]
Yu, Ming-Chin [1 ]
Lo, Yung-Feng [1 ]
Dabora, Muawiya A. [2 ]
Chang, Hsien-Kun [3 ]
Lin, Yung-Chang [3 ]
Ueng, Shir-Hwa [4 ]
Chen, Shin-Cheh [1 ]
机构
[1] Chang Gung Mem Hosp Linkou, Dept Gen Surg, 5,Fusing St, Taoyuan 333, Taiwan
[2] Khartoum Breast Care Ctr, Khartoum, Sudan
[3] Chang Gung Mem Hosp Linkou, Dept Med Oncol, Taoyuan, Taiwan
[4] Chang Gung Mem Hosp Linkou, Dept Pathol, Taoyuan, Taiwan
关键词
Neoadjuvant chemotherapy; Pathological complete response; Breast cancer; Age; TRIAL-CALGB; 150007/150012; SURGICAL ADJUVANT BREAST; CONSERVING THERAPY; MOLECULAR SUBTYPES; YOUNG-WOMEN; SURVIVAL; CONSERVATION; DOCETAXEL; CONSENSUS; ISSUES;
D O I
10.1016/j.bj.2018.10.007
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Background: Neoadjuvant chemotherapy (NAC) is the standard approach for downstaging of locally advanced breast cancer and can improve breast conservation rates. A pathological complete response (pCR) after NAC associated with favorable long-term outcomes has been described. There is still a high locoregional recurrence (LRR) rate after NAC and the influence of age on LRR after NAC is unclear. This study analyzed the relationship between age and LRR after NAC. Methods: Two hundred and sixty-three patients with invasive breast cancer who received NAC followed by mastectomy or breast conserving surgery (BCS) were enrolled. Concurrent weekly epirubicin and docetaxel was the NAC regimen. Results: Twenty-nine patients (11%) achieved a pCR after NAC. In univariate analysis, age <50 years, luminal B (HER2 positive) subtype, HER2 overexpression subtype, and triple-negative subtype were factors to predict a pCR. In multivariate analysis, age <50 years, luminal B (HER2 positive) type, HER2 overexpression, and triple-negative subtype were the independent factors to predict a pCR. No patients in the pCR group developed LRR compared with 31 patients in the non-pCR group. Eleven patients (6.9%) in the younger group (age <50 years) developed LRR compared with 20 patients (19.4%) in the older group (age >= 50 years). In multivariate analysis, younger age (<50 years) was the only independent prognostic factor for a LRR-free survival. Conclusion: Younger age can predict a pCR and is an independent prognostic factor for LRR in locally advanced breast cancer patients after NAC as concurrent epirubicin and docetaxel.
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收藏
页码:66 / 74
页数:9
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