外科理论与实践2023，Vol.28Issue(5)：469-476,8.DOI:10.16139/j.1007-9610.2023.05.13
HER2阳性乳腺癌接受曲妥珠单抗辅助治疗病人预后分析(附1246例报告)
Prognostic analysis of the patients with HER2-positive breast cancer adjuvant treated with trastuzumab:a report of 1 246 cases
李岳峰 1洪进 2李志安 1阮国栋 1陈伟国2
作者信息
- 1. 绍兴第二医院肿瘤外科,浙江 绍兴 312000
- 2. 上海交通大学医学院附属瑞金医院普外科 乳腺疾病诊治中心,上海 200025
- 折叠
摘要
Abstract
Objective To analyze the prognostic factors in the patients with HER2-positive breast cancer adjuvant treated with trastuzumab.Methods We conducted a retrospective analysis of clinical data of 1 246 patients diagnosed with HER2-positive breast cancer between January 2009 and December 2019 who received treatment with trastuzumab.We investigated the factors impacting their prognosis by the Log-rank test univariate analysis and multivariate COX regression analysis.Results HER2-positive patients treated with trastuzumab had a poor prognosis in pT2-3(HR=2.10,P=0.003),pN2-3(HR=2.81,P<0.001),and no endocrine therapy(HR=2.50,P<0.001),and that had a better prognosis combined with taxane or other chemotherapy regimens(HR=0.40,P=0.017).We divided the patients into two subgroups according to the status of lymph node metastasis,and we found that in the negative lymph nodes group the patients with pT2-3 stage had poor prognosis(P=0.020),while the patients combined with taxane or other chemotherapy had better prognosis(P=0.032).In the positive lymph nodes group the patients with pT2-3 stage and no endocrine therapy had poor prognosis(P=0.012,P=0.001).Conclusions The patients with HER2-positive breast cancer treated with trastuzumab can be managed in different categories,for individuals without lymph node involvement and small tumor sizes,combining therapy with non-anthracycline chemotherapy is preferable for achieving improved outcomes,for patients with lymph node metastasis and large tumor sizes,if chemotherapy options are available,it is more recommended to use an anthracycline-free regimen to ensure the same prognosis while reducing the harm caused by the toxic side effects of chemotherapy.关键词
HER2阳性乳腺癌/曲妥珠单抗/淋巴结转移/预后Key words
HER2-positive breast cancer/Trastuzumab/Lymph node metastasis/Prognosis分类
医药卫生引用本文复制引用
李岳峰,洪进,李志安,阮国栋,陈伟国..HER2阳性乳腺癌接受曲妥珠单抗辅助治疗病人预后分析(附1246例报告)[J].外科理论与实践,2023,28(5):469-476,8.
