Prognostic analysis of the patients with HER2-positive breast cancer adjuvant treated with trastuzumab:a report of 1 246 cases
10.16139/j.1007-9610.2023.05.13
- VernacularTitle: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)
- Author:
Yuefeng LI
1
;
Jin HONG
;
Zhian LI
;
Guodong RUAN
;
Weiguo CHEN
Author Information
1. 绍兴第二医院肿瘤外科,浙江 绍兴 312000
- Keywords:
HER2-positive breast cancer;
Trastuzumab;
Lymph node metastasis;
Prognosis
- From:
Journal of Surgery Concepts & Practice
2023;28(5):469-476
- CountryChina
- Language:Chinese
-
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.
