Risk factors for late recurrence and postrelapse survival in estrogen receptor (ER)-positive, human epidermal growth factor receptor (HER) 2-negative breast cancer after 5 years of endocrine therapy.

Autor: Ito M; Department of Breast Surgery, Tohoku Kosai Hospital, Sendai, Japan. Electronic address: ma-ito@tohokukosai.com., Amari M; Department of Breast Surgery, Tohoku Kosai Hospital, Sendai, Japan., Sato A; Department of Breast Surgery, Tohoku Kosai Hospital, Sendai, Japan., Hikichi M; Department of Breast Surgery, Tohoku Kosai Hospital, Sendai, Japan., Sakamoto A; Department of Breast Surgery, Tohoku Kosai Hospital, Sendai, Japan., Yamazaki A; Department of Breast and Endocrine Surgery, Tohoku University School of Medicine, Sendai, Japan., Saji S; Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2024 Feb; Vol. 73, pp. 103604. Date of Electronic Publication: 2023 Nov 19.
DOI: 10.1016/j.breast.2023.103604
Abstrakt: It is unclear which patients with ER-positive, HER2-negative breast cancer benefit from extended endocrine therapy beyond 5 years. Prognostic factors for late-recurring breast cancer postrelapse survival have been reported. We retrospectively analyzed data from 892 patients with ER-positive and HER2-negative invasive breast cancer who were disease-free after completing a 5-year adjuvant endocrine therapy. Patients were then classified as high-risk (positive lymph nodes, large tumor size, high tumor grade) or low-risk. High-risk patients were divided into extended endocrine therapy and stop groups. Comparisons were made using propensity score matching, and the benefits of extended endocrine therapy for high-risk patients and prognostic factors for postrelapse survival were assessed. The high- and low-risk groups comprised 444 and 448 patients, respectively. The 10-year distant disease-free survival (DDFS) rates were 96.3 % (95 % confidence interval [CI] 0.912-0.985) and 86.5 % (95 % CI 0.798-0911) in the extended and stop groups, respectively (P = 0.00382). Cox proportional hazards model revealed that extended endocrine therapy promoted greater reduction in distant metastasis risk than 5-year endocrine therapy in high-risk populations (hazard ratio [HR] 0.27; 95 % CI 0.11-0.68; P = 0.0054). Postrelapse survival was significantly different in patients with DDFS ≥7 years (HR 0.24; 95 % CI 0.072-0.81; P = 0.021) and those with better response to first-line treatment (HR 0.072; 95 % CI, 0.058-0.90; P = 0.041). Patients with risk factors for late recurrence should be considered for extended endocrine therapy. Longer DDFS and response to first-line treatment may be a prognostic factor for postrelapse survival after late recurrence.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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