■乳腺癌患者新辅助化疗(NAC)后的残留疾病预测结果比病理完全缓解更差。基于残留肿瘤的解剖部位的不同预后影响尚未得到很好的研究。
■该研究旨在评估NAC后具有不同残留肿瘤部位的乳腺癌患者的无病生存期(DFS),并开发出预测这些患者1至3年DFS的列线图。
■一项回顾性队列研究。
■NAC后953例淋巴结阳性乳腺癌患者的回顾性分析。患者分为三组:乳腺残留病(RDB),淋巴结残留病(RDN),以及两者的残留病(RDBN)。组间比较DFS。以7:3的比例将患者分为训练集和验证集。分析了DFS的预后因素,以建立列线图预测模型。
■RDB患者的3年DFS优于94.6%,RDN为85.2%,RDBN为81.8%(p<0.0001)。临床T分期,N级,分子亚型,在单因素和多因素分析中,术后pN分期与DFS独立相关.结合临床肿瘤淋巴结转移(TNM)分期的列线图,分子亚型,病理反应表现出良好的辨别力(C指数0.748训练,0.796验证队列),和校准。
■残留病的位置具有预后意义,节点残差预测较差的DFS。经验证的列线图使个性化DFS预测能够指导治疗决策。
了解乳腺癌治疗后残留肿瘤位置对预后的影响接受新辅助化疗后,手术前缩小肿瘤的治疗方法,一些乳腺癌患者可能仍有残留的肿瘤细胞。我们的研究重点是这些剩余肿瘤的位置-无论是在乳房中,淋巴结,或两者-影响癌症在未来1至3年内不复发的可能性。这种可能性被称为“无病生存”(DFS)。我们分析了953例接受新辅助化疗但仍有残留肿瘤的乳腺癌患者的数据。通过比较肿瘤保留在不同位置的患者的DFS,我们发现残留肿瘤的具体位置显著影响患者的长期健康和康复。此外,我们开发了一种称为“列线图”的预测工具,以帮助医生和患者评估未来1至3年内癌症复发的风险。这个工具考虑了各种因素,如肿瘤的大小和类型,以及化疗后残留肿瘤的位置和程度。我们的研究为了解乳腺癌治疗后复发的风险提供了新的见解。这项工作不仅增强了我们对乳腺癌管理的理解,而且还有助于为将来的患者制定更个性化和有效的治疗策略。
UNASSIGNED: Residual disease after neoadjuvant chemotherapy (NAC) in breast cancer patients predicts worse outcomes than pathological complete response. Differing prognostic impacts based on the anatomical site of residual tumors are not well studied.
UNASSIGNED: The study aims to assess disease-free survival (DFS) in breast cancer patients with different residual tumor sites following NAC and to develop a nomogram for predicting 1- to 3-year DFS in these patients.
UNASSIGNED: A retrospective cohort study.
UNASSIGNED: Retrospective analysis of 953 lymph node-positive breast cancer patients with residual disease post-NAC. Patients were categorized into three groups: residual disease in breast (RDB), residual disease in lymph nodes (RDN), and residual disease in both (RDBN). DFS compared among groups. Patients were divided into a training set and a validation set in a 7:3 ratio. Prognostic factors for DFS were analyzed to develop a nomogram prediction model.
UNASSIGNED: RDB patients had superior 3-year DFS of 94.6% versus 85.2% for RDN and 81.8% for RDBN (p < 0.0001). Clinical T stage, N stage, molecular subtype, and postoperative pN stage were independently associated with DFS on both univariate and multivariate analyses. Nomogram integrating clinical tumor-node-metastasis (TNM) stage, molecular subtype, pathological response demonstrated good discrimination (C-index 0.748 training, 0.796 validation cohort), and calibration.
UNASSIGNED: The location of residual disease has prognostic implications, with nodal residuals predicting poorer DFS. The validated nomogram enables personalized DFS prediction to guide treatment decisions.
Understanding the impact of residual tumor location on prognosis after breast cancer treatment After receiving neoadjuvant chemotherapy, a treatment to shrink tumors before surgery, some breast cancer patients may still have residual tumor cells. Our study focuses on how the location of these remaining tumors – whether in the breast, lymph nodes, or both – affects the likelihood of the cancer not returning within the next 1 to 3 years. This likelihood is known as ‘disease-free survival’ (DFS). We analyzed data from 953 breast cancer patients who underwent neoadjuvant chemotherapy and still had residual tumors. By comparing DFS among patients with tumors remaining in different locations, we discovered that the specific location of the residual tumor significantly impacts the patient’s long-term health and recovery. Additionally, we developed a predictive tool called a ‘nomogram’ to help doctors and patients assess the risk of cancer recurrence in the next 1 to 3 years. This tool considers various factors such as the size and type of the tumor, as well as the location and extent of the residual tumor after chemotherapy. Our research offers new insights into understanding the risk of recurrence after breast cancer treatment. This work not only enhances our comprehension of breast cancer management but also aids in devising more personalized and effective treatment strategies for patients in the future.