The effect of (neo)adjuvant chemotherapy on long-term survival outcomes in patients with invasive lobular breast cancer treated with endocrine therapy: A retrospective cohort study.

Autor: Öztekin S; Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands., Hooning MJ; Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands., van Deurzen CHM; Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands., Dietvorst AHP; Department of Medical Oncology, Breast Cancer Center South Holland South, Van Weel Bethesda Hospital, Dirksland, the Netherlands., Drooger JC; Department of Medical Oncology, Breast Cancer Center South Holland South, Ikazia Hospital, Rotterdam, the Netherlands., Kitzen JJEM; Department of Medical Oncology, Albert Schweitzer Hospital, Dordrecht, the Netherlands., Martens JWM; Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands., van der Padt-Pruijsten A; Department of Medical Oncology, Breast Cancer Center South Holland South, Maasstad Hospital, Rotterdam, the Netherlands., Vastbinder MB; Department of Medical Oncology, IJsselland Hospital, Capelle aan den IJssel, the Netherlands., Zuetenhorst H; Department of Medical Oncology, Franciscus Gasthuis en Vlietland, Rotterdam, the Netherlands., Heemskerk-Gerritsen BAM; Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands., Jager A; Department of Medical Oncology, Erasmus Medical Center (MC) Cancer Institute, Rotterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2024 Mar 15; Vol. 130 (6), pp. 927-935. Date of Electronic Publication: 2023 Nov 20.
DOI: 10.1002/cncr.35125
Abstrakt: Background: Despite histological and molecular differences between invasive lobular carcinoma (ILC) and invasive carcinoma of no special type, according to national treatment guidelines no distinction is made regarding the use of (neo)adjuvant chemotherapy. Studies on the long-term outcome of chemotherapy in patients with ILC are scarce and show inconclusive results.
Methods: All patients with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative ILC with an indication for chemotherapy treated with adjuvant endocrine therapy were selected from the Erasmus Medical Center Breast Cancer database. Cox proportional hazards models were used to estimate the effect of chemotherapy on recurrence-free survival (RFS), breast cancer-specific survival (BCSS), and overall survival (OS).
Results: A total of 520 patients were selected, of whom 379 were treated with chemotherapy and 141 were not. Patients in the chemotherapy group were younger (51 vs. 61 years old; p < .001), had a higher T status (T3+, 33% vs. 14%; p < .001), and more often had lymph node involvement (80% vs. 49%; p < .001) in comparison to the no-chemotherapy group. After adjusting for confounders, chemotherapy treatment was not associated with better RFS (hazard ratio [HR], 1.20; 95% confidence interval [CI], 0.63-2.31), BCSS (HR, 1.24; 95% CI, 0.60-2.58), or OS (HR, 0.97; 95% CI, 0.56-1.66). This was also reflected by adjusted Cox survival curves in the chemotherapy versus no-chemotherapy group for RFS (75% vs. 79%), BCSS (80% vs. 84%), and OS (72% vs. 71%).
Conclusions: Chemotherapy is not associated with improved RFS, BCSS, or OS for patients with ER+/HER2- ILC treated with adjuvant endocrine therapy and with an indication for chemotherapy.
(© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)
Databáze: MEDLINE
Externí odkaz: