Impact of adjuvant chemotherapy on T1N0M0 breast cancer patients: a propensity score matching study based on SEER database and external cohort

被引：5

作者：

Shen, Kaiwen ^{[1
]}

Yao, Longdi ^{[2
]}

Zhu, Jingyuan ^{[1
]}

Gu, Ximing ^{[1
]}

Wang, Jie ^{[1
]}

Qian, Wei ^{[3
]}

Zheng, Zhijian ^{[4
]}

Fu, Deyuan ^{[5
]}

Wu, Song ^{[6
]}

机构：

[1] Tradit Chinese Med Hosp Kunshan, Dept Gen Surg, Suzhou 215000, Jiangsu, Peoples R China

[2] Changxing Hosp Tradit Chinese Med, Dept Gen Surg, Huzhou 313100, Zhejiang, Peoples R China

[3] Nanjing Med Univ, Nanjing 211166, Jiangsu, Peoples R China

[4] First Peoples Hosp Wenling, Dept Gen Surg, Wenling 317500, Zhejiang, Peoples R China

[5] Yangzhou Univ, Northern Jiangsu Peoples Hosp, Dept Thyroid & Breast Surg, Med Acad, Nantong Xi Rd, Yangzhou 225001, Jiangsu, Peoples R China

[6] First Peoples Hosp Wenling, Dept Thyroid & Breast Surg, Chuanan Nan Rd,Chengxi St, Wenling 317500, Zhejiang, Peoples R China

来源：

BMC CANCER | 2022年 / 22卷 / 01期

关键词：

Adjuvant chemotherapy; Breast neoplasms; Small tumor; Prognosis; Molecular subtype; Lymph node-negative; CLINICAL-PRACTICE; 21-GENE ASSAY; SURVIVAL; MORTALITY; THERAPY; SIZE; VALIDATION; RECURRENCE; CENTIMETER; T1A; BNOMO;

D O I：

10.1186/s12885-022-09952-z

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background There is no clear consensus on the benefits of adjuvant chemotherapy for tumor-node-metastasis (TNM) stage T1 (T1N0M0) breast cancer (BC). Our study investigated the effects of adjuvant chemotherapy on T1N0M0 BC patients. Methods Seventy-five thousand one hundred thirty-nine patients diagnosed with T1N0M0 BC were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox analyses were performed to investigate the effects of adjuvant chemotherapy on T1a, T1b, and T1cN0M0 BC, including various tumor grades, and four molecular subtypes. Propensity score matching (PSM) was used to eliminate confounding factors and further compare the results between adjuvant chemotherapy and no adjuvant chemotherapy. Additionally, 545 T1N0M0 BC patients treated at the Northern Jiangsu People's Hospital were included as an independent external validation cohort. Univariate and multivariate Cox analyses were used to confirm the effects of adjuvant chemotherapy in T1a, T1b, and T1cN0M0 BC. Survival curves for the different tumor grades and molecular subtypes were plotted using the Kaplan-Meier method. Results Adjuvant chemotherapy demonstrated a statistically significant improvement in overall survival (OS) in T1b and T1c BC, but not in T1a BC. Within T1b BC, adjuvant chemotherapy was found to have effects on grade III, and hormone receptor + (HoR +)/human epidermal growth factor receptor 2 + (HER2 +), HoR-/HER2 + , and HoR-/HER2- molecular subtypes, respectively. Adjuvant chemotherapy was beneficial to OS for grade II/III and T1c BC. Identical results were obtained after PSM. We also obtained similar results with external validation cohort, except that adjuvant chemotherapy made a difference in grade II and T1b BC of the external validation dataset. Conclusions Partial T1N0M0 BC patients with grade III T1bN0M0, patients with tumor grade II and III T1cN0M0, and excluding those with HoR + /HER2- subtype tumors, could obtain OS benefits from adjuvant chemotherapy.

引用

页数：15

共 51 条

[1]

Abe O, 2005, LANCET, V365, P1687, DOI 10.1016/s0140-6736(05)66544-0

[2] Adjuvant chemotherapy for small, lymph node-negative, triple-negative breast cancer: A single-center study and a meta-analysis of the published literature [J].

An, Xin ;

Lei, Xuefen ;

Huang, Riqing ;

Luo, Rongzhen ;

Li, Haifeng ;

Xu, Fei ;

Yuan, Zhongyu ;

Wang, Shusen ;

de Nonneville, Alexandre ;

Goncalves, Anthony ;

Houvenaeghel, Gilles ;

Li, Jibin ;

Xue, Cong ;

Shi, Yanxia .

CANCER, 2020, 126 :3837-3846

[3]

[Anonymous], 2019, NCCN CLIN PRACTICE G

[4] Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies [J].

Austin, Peter C. .

PHARMACEUTICAL STATISTICS, 2011, 10 (02) :150-161

[5] Effect of screening and adjuvant therapy on mortality from breast cancer [J].

Berry, DA ;

Cronin, KA ;

Plevritis, SK ;

Fryback, DG ;

Clarke, L ;

Zelen, M ;

Mandelblatt, JS ;

Yakovlev, AY ;

Habbema, JDF ;

Feuer, EJ .

NEW ENGLAND JOURNAL OF MEDICINE, 2005, 353 (17) :1784-1792

[6] Spectrum of very early breast cancer in a setting without organised screening [J].

Bhoo-Pathy, N. ;

Subramaniam, S. ;

Taib, N. A. ;

Hartman, M. ;

Alias, Z. ;

Tan, G-H ;

Ibrahim, R. I. ;

Yip, C-H ;

Verkooijen, H. M. .

BRITISH JOURNAL OF CANCER, 2014, 110 (09) :2187-2194

[7] Impact of adjuvant chemotherapy on survival of women with T1N0M0, hormone receptor negative breast cancer [J].

Bhoo-Pathy, Nanthini Thevi ;

Inaida, Shinako ;

Tanaka, Shiro ;

Taib, Nur Aishah ;

Yip, Cheng-Har ;

Saad, Marniza ;

Kawakami, Koji ;

Bhoo-Pathy, Nirmala .

CANCER EPIDEMIOLOGY, 2017, 48 :56-61

[8] 70-Gene Signature as an Aid to Treatment Decisions in Early-Stage Breast Cancer [J].

Cardoso, F. ;

van't Veer, L. J. ;

Bogaerts, J. ;

Slaets, L. ;

Viale, G. ;

Delaloge, S. ;

Pierga, J. -Y. ;

Brain, E. ;

Causeret, S. ;

DeLorenzi, M. ;

Glas, A. M. ;

Golfinopoulos, V. ;

Goulioti, T. ;

Knox, S. ;

Matos, E. ;

Meulemans, B. ;

Neijenhuis, P. A. ;

Nitz, U. ;

Passalacqua, R. ;

Ravdin, P. ;

Rubio, I. T. ;

Saghatchian, M. ;

Smilde, T. J. ;

Sotiriou, C. ;

Stork, L. ;

Straehle, C. ;

Thomas, G. ;

Thompson, A. M. ;

van der Hoeven, J. M. ;

Vuylsteke, P. ;

Bernards, R. ;

Tryfonidis, K. ;

Rutgers, E. ;

Piccart, M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2016, 375 (08) :717-729

[9] Polychemotherapy for early breast cancer: an overview of the randomised clinical trials with quality-adjusted survival analysis [J].

Cole, BF ;

Gelber, RD ;

Gelber, S ;

Coates, AS ;

Goldhirsch, A .

LANCET, 2001, 358 (9278) :277-286

[10] De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017 [J].

Curigliano, G. ;

Burstein, H. J. ;

Winer, E. P. ;

Gnant, M. ;

Dubsky, P. ;

Loibl, S. ;

Colleoni, M. ;

Regan, M. M. ;

Piccart-Gebhart, M. ;

Senn, H. -J. ;

Thurlimann, B. ;

Andre, F. ;

Baselga, J. ;

Bergh, J. ;

Bonnefoi, H. ;

Brucker, S. Y. ;

Cardoso, F. ;

Carey, L. ;

Ciruelos, E. ;

Cuzick, J. ;

Denkert, C. ;

Di Leo, A. ;

Ejlertsen, B. ;

Francis, P. ;

Galimberti, V. ;

Garber, J. ;

Gulluoglu, B. ;

Goodwin, P. ;

Harbeck, N. ;

Hayes, D. F. ;

Huang, C. -S. ;

Huober, J. ;

Khaled, H. ;

Jassem, J. ;

Jiang, Z. ;

Karlsson, P. ;

Morrow, M. ;

Orecchia, R. ;

Osborne, K. C. ;

Pagani, O. ;

Partridge, A. H. ;

Pritchard, K. ;

Ro, J. ;

Rutgers, E. J. T. ;

Sedlmayer, F. ;

Semiglazov, V. ;

Shao, Z. ;

Smith, I. ;

Toi, M. ;

Tutt, A. .

ANNALS OF ONCOLOGY, 2017, 28 (08) :1700-1712

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