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Significance of intrinsic breast cancer subtypes on the long-term prognosis after neoadjuvant chemotherapy

机译:内在乳腺癌亚型对新辅助化疗后长期预后的重要性

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摘要

Abstract Background The prognosis of breast cancer and the treatment response to neoadjuvant chemotherapy (NAC) differ depending on the intrinsic molecular subtypes. We evaluated the prognostic significance of immunohistological subtypes in patients with recurrent breast cancer after treatment with NAC and surgery. Methods A total of 237 patients with breast cancer treated with NAC and subsequent curative surgery between 2007 and 2015 were analyzed. The correlation between intrinsic molecular subtypes and clinicopathological features, prognosis, and pathological complete response (pCR) rate of NAC were investigated retrospectively. Results There were 55 (23.2%) patients with recurrence after surgery. No significant difference in post-recurrence survival (PRS) was noted among the subtypes (p = 0.397). In patients with estrogen receptor-positive human epidermal growth factor receptor (HER) 2-negative (luminal) malignancy, PRS was significantly better in the pCR group than in the non-pCR group (p = 0.031). Conversely, pCR was not a significant predictor of improved PRS in patients with triple-negative breast cancer (TNBC; p = 0.329). Multivariate analysis revealed that the efficacy of NAC [hazard ratio (HR) 300.204, p < 0.001] and the initial metastasis site (HR 15.037, p = 0.005) were independent predictors for PRS in patients with luminal breast cancer, while Ki-67 (HR 51.171, p = 0.020) and the initial metastasis site (HR 13.318, p = 0.048) were independent predictors for PRS in patients with TNBC. Conclusions The prognostic factors for each intrinsic subtype should be evaluated separately in patients with recurrent breast cancer following NAC and surgery.
机译:摘要背景乳腺癌的预后和对Neoadjuvant化疗(NAC)的治疗反应根据内在分子亚型而不同。我们评估了NAC和手术治疗后复发性乳腺癌患者中免疫组织亚型的预后意义。方法分析了在2007年至2015年间治疗的237例患有NAC和随后的疗法手术治疗的乳腺癌患者。回顾性地研究了内在分子亚型与临床病理学特征,预后和病理完全反应(PCR)率的相关性。结果手术后有55例(23.2%)患者复发。在亚型中注意到后复发后存活率(PRS)的显着差异(P = 0.397)。在雌激素受体阳性人体表皮生长因子受体(她)2阴性(腔)恶性肿瘤的患者中,PCR组在非PCR组中显着更好(P = 0.031)。相反,PCR不是三阴性乳腺癌(TNBC; P = 0.329)的改善PRS的显着预测因子。多变量分析显示NAC [危害比(HR)300.204,P <0.001]和初始转移位点(HR 15.037,P = 0.005)的疗效是患有腔乳腺癌患者的PRS的独立预测因子,而KI-67( HR 51.171,P = 0.020)和初始转移位点(HR 13.318,P = 0.048)是TNBC患者的PRS的独立预测因子。结论NAC和手术后经常性乳腺癌患者分别评估每个内在亚型的预后因素。

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