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Evaluation of the ability of the Clinical Treatment Score at 5?years (CTS5) compared to other risk stratification methods to predict the response to an extended endocrine therapy in breast cancer patients

机译:评估临床治疗得分在5?多年(CTS5)与其他风险分层方法相比,以预测乳腺癌患者的延长内分泌治疗的反应

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Purpose Extension of adjuvant endocrine therapy (ET) reduces the risk of recurrence in women diagnosed with ER-positive breast cancers, but a significant benefit is unlikely to happen to all individual patients. This study is aimed at evaluating the ability of different clinical late distant recurrence (LDR) risk stratification methods and in particular the clinical treatment score at 5?years (CTS5) to predict the response to extended adjuvant ET. Methods 783 patients diagnosed with ER+?BC between 1988 and 2014 at Umberto I Hospital of Turin, of which 180 received an extended adjuvant ET, were retrospectively selected. They were stratified according to pT, pN, disease stage, tumor grade, Ki67 level, progesterone receptor status and CTS5. The primary endpoint was LDR rate. LDR rates according to ET duration were confronted in each subgroup. Result The median duration of extended ET was 7?years (6–10). Median follow-up from diagnosis was 9?years (6–26). Retrospective risk stratification according to tumor size, nodal status, disease stage, tumor grade, Ki67 level, and progesterone receptor status did not appear to be able to predict the response to extended ET. In the CTS5 high-risk subgroup instead, the risk of developing an LDR was significantly lower in the patients who underwent extended ET compared to standard ET (HR 0.37, 95% CI 0.15–0.91), while no significant benefit was demonstrated for low and intermediate-risk patients. Conclusions Risk stratification according to CTS5 appeared to be predictive of the response to extended endocrine therapy in our population of real-life pre and postmenopausal patients.
机译:佐剂内分泌治疗的目的延伸(ET)降低了诊断患有ER阳性乳腺癌的女性复发的风险,但所有个体患者都不太可能发生重大好处。本研究旨在评估不同临床晚期复发(LDR)风险分层方法的能力,特别是临床治疗得分在5?年(CTS5)预测延长佐剂ET的反应。方法回顾性地选择1988年至2014年在本着的翁伯托I医院诊断为ER +(2014年间)的783例患者,其中180名接受了延长的佐剂ET。它们根据Pt,pn,疾病阶段,肿瘤等级,Ki67水平,孕酮受体状态和CTS5分层。主要端点是LDR率。根据ET持续时间的LDR率在每个亚组中面临。结果延期等中位数持续时间为7?年(6-10)。诊断中的中位随访是9?年(6-26)。回顾性风险分层根据肿瘤大小,节点状态,疾病阶段,肿瘤等级,KI67水平和孕酮受体状态似乎无法预测对延伸等的反应。在CTS5高危亚组中,与标准ET(HR 0.37,95%CI 0.15-0.91相比,延长ET的患者在延长ET的患者中,开发LDR的风险显着降低,同时对低低而没有显着的益处。中等风险患者。结论根据CTS5的风险分层似乎预测了对我们现实生命前和绝经后患者人口延长内分泌治疗的反应。

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