A population-based recurrence risk management study of patients with pT1 node-negative HER2+ breast cancer: a National Clinical Database study

Makoto Kubo, Masaaki Kawai, Hiraku Kumamaru, Hiroaki Miyata, Kenji Tamura, Masayuki Yoshida, Etsuyo Ogo, Masayuki Nagahashi, Sota Asaga, Yasuyuki Kojima, Takayuki Kadoya, Kenjiro Aogi, Naoki Niikura, Minoru Miyashita, Kotaro Iijima, Naoki Hayashi, Yutaka Yamamoto, Shigeru Imoto, Hiromitsu Jinno

研究成果: ジャーナルへの寄稿記事

抄録

Purpose: Recurrence risk management of patients with small (≤ 2 cm), node-negative, human epidermal growth factor receptor 2 (HER2)-positive breast cancer remains challenging. We studied the effects of adjuvant chemotherapy and/or trastuzumab and survival outcomes among these patients, using data from the population-based Japanese National Clinical Database (NCD). Methods: We identified a cohort of 2736 breast cancer patients with HER2+ pT1N0 disease: 489 pT1a, 642 pT1b, and 1623 pT1c. The median observation period was 76 months, and the 5-year follow-up rate was 48.2%. The number of events was 212 for disease-free survival (DFS), 40 for breast cancer-specific survival, and 84 for overall survival (OS). Results: There were 24.5% of pT1a, 51.9% of pT1b, and 63.3% of pT1c patients who were treated systemically after surgery. OS in pT1b (logrank test; p = 0.03) and DFS in pT1c (logrank test; p < 0.001) were significantly improved in treated compared with untreated patients. In the Cox proportional hazards model, treated patients had significantly longer OS than untreated patients in pT1b (hazard ratio (HR) 0.20) and pT1c (HR 0.54) groups. Estrogen receptor-negative tumors was also a significant predictor of survival in pT1c (HR 2.01) but not pT1ab patients. Furthermore, HR was greater in patients aged ≤ 35 years (3.18) compared to that in patients aged 50–69 years in the pT1b group. Conclusions: NCD data revealed that systemic treatment improved OS in pT1bc but not in pT1a node-negative HER2+ breast cancer patients. Future observational research using big-sized data is expected to play an important role in optimizing treatment for patients with early-stage breast cancer.

元の言語英語
ページ(範囲)647-656
ページ数10
ジャーナルBreast Cancer Research and Treatment
178
発行部数3
DOI
出版物ステータス受理済み/印刷中 - 1 1 2019

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Risk Management
Databases
Breast Neoplasms
Recurrence
Population
Survival
Disease-Free Survival
Clinical Studies
human ERBB2 protein
Adjuvant Chemotherapy
Proportional Hazards Models
Estrogen Receptors
Observation

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

これを引用

A population-based recurrence risk management study of patients with pT1 node-negative HER2+ breast cancer : a National Clinical Database study. / Kubo, Makoto; Kawai, Masaaki; Kumamaru, Hiraku; Miyata, Hiroaki; Tamura, Kenji; Yoshida, Masayuki; Ogo, Etsuyo; Nagahashi, Masayuki; Asaga, Sota; Kojima, Yasuyuki; Kadoya, Takayuki; Aogi, Kenjiro; Niikura, Naoki; Miyashita, Minoru; Iijima, Kotaro; Hayashi, Naoki; Yamamoto, Yutaka; Imoto, Shigeru; Jinno, Hiromitsu.

:: Breast Cancer Research and Treatment, 巻 178, 番号 3, 01.12.2019, p. 647-656.

研究成果: ジャーナルへの寄稿記事

Kubo, M, Kawai, M, Kumamaru, H, Miyata, H, Tamura, K, Yoshida, M, Ogo, E, Nagahashi, M, Asaga, S, Kojima, Y, Kadoya, T, Aogi, K, Niikura, N, Miyashita, M, Iijima, K, Hayashi, N, Yamamoto, Y, Imoto, S & Jinno, H 2019, 'A population-based recurrence risk management study of patients with pT1 node-negative HER2+ breast cancer: a National Clinical Database study', Breast Cancer Research and Treatment, 巻. 178, 番号 3, pp. 647-656. https://doi.org/10.1007/s10549-019-05413-7
Kubo, Makoto ; Kawai, Masaaki ; Kumamaru, Hiraku ; Miyata, Hiroaki ; Tamura, Kenji ; Yoshida, Masayuki ; Ogo, Etsuyo ; Nagahashi, Masayuki ; Asaga, Sota ; Kojima, Yasuyuki ; Kadoya, Takayuki ; Aogi, Kenjiro ; Niikura, Naoki ; Miyashita, Minoru ; Iijima, Kotaro ; Hayashi, Naoki ; Yamamoto, Yutaka ; Imoto, Shigeru ; Jinno, Hiromitsu. / A population-based recurrence risk management study of patients with pT1 node-negative HER2+ breast cancer : a National Clinical Database study. :: Breast Cancer Research and Treatment. 2019 ; 巻 178, 番号 3. pp. 647-656.
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abstract = "Purpose: Recurrence risk management of patients with small (≤ 2 cm), node-negative, human epidermal growth factor receptor 2 (HER2)-positive breast cancer remains challenging. We studied the effects of adjuvant chemotherapy and/or trastuzumab and survival outcomes among these patients, using data from the population-based Japanese National Clinical Database (NCD). Methods: We identified a cohort of 2736 breast cancer patients with HER2+ pT1N0 disease: 489 pT1a, 642 pT1b, and 1623 pT1c. The median observation period was 76 months, and the 5-year follow-up rate was 48.2{\%}. The number of events was 212 for disease-free survival (DFS), 40 for breast cancer-specific survival, and 84 for overall survival (OS). Results: There were 24.5{\%} of pT1a, 51.9{\%} of pT1b, and 63.3{\%} of pT1c patients who were treated systemically after surgery. OS in pT1b (logrank test; p = 0.03) and DFS in pT1c (logrank test; p < 0.001) were significantly improved in treated compared with untreated patients. In the Cox proportional hazards model, treated patients had significantly longer OS than untreated patients in pT1b (hazard ratio (HR) 0.20) and pT1c (HR 0.54) groups. Estrogen receptor-negative tumors was also a significant predictor of survival in pT1c (HR 2.01) but not pT1ab patients. Furthermore, HR was greater in patients aged ≤ 35 years (3.18) compared to that in patients aged 50–69 years in the pT1b group. Conclusions: NCD data revealed that systemic treatment improved OS in pT1bc but not in pT1a node-negative HER2+ breast cancer patients. Future observational research using big-sized data is expected to play an important role in optimizing treatment for patients with early-stage breast cancer.",
author = "Makoto Kubo and Masaaki Kawai and Hiraku Kumamaru and Hiroaki Miyata and Kenji Tamura and Masayuki Yoshida and Etsuyo Ogo and Masayuki Nagahashi and Sota Asaga and Yasuyuki Kojima and Takayuki Kadoya and Kenjiro Aogi and Naoki Niikura and Minoru Miyashita and Kotaro Iijima and Naoki Hayashi and Yutaka Yamamoto and Shigeru Imoto and Hiromitsu Jinno",
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T1 - A population-based recurrence risk management study of patients with pT1 node-negative HER2+ breast cancer

T2 - a National Clinical Database study

AU - Kubo, Makoto

AU - Kawai, Masaaki

AU - Kumamaru, Hiraku

AU - Miyata, Hiroaki

AU - Tamura, Kenji

AU - Yoshida, Masayuki

AU - Ogo, Etsuyo

AU - Nagahashi, Masayuki

AU - Asaga, Sota

AU - Kojima, Yasuyuki

AU - Kadoya, Takayuki

AU - Aogi, Kenjiro

AU - Niikura, Naoki

AU - Miyashita, Minoru

AU - Iijima, Kotaro

AU - Hayashi, Naoki

AU - Yamamoto, Yutaka

AU - Imoto, Shigeru

AU - Jinno, Hiromitsu

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Recurrence risk management of patients with small (≤ 2 cm), node-negative, human epidermal growth factor receptor 2 (HER2)-positive breast cancer remains challenging. We studied the effects of adjuvant chemotherapy and/or trastuzumab and survival outcomes among these patients, using data from the population-based Japanese National Clinical Database (NCD). Methods: We identified a cohort of 2736 breast cancer patients with HER2+ pT1N0 disease: 489 pT1a, 642 pT1b, and 1623 pT1c. The median observation period was 76 months, and the 5-year follow-up rate was 48.2%. The number of events was 212 for disease-free survival (DFS), 40 for breast cancer-specific survival, and 84 for overall survival (OS). Results: There were 24.5% of pT1a, 51.9% of pT1b, and 63.3% of pT1c patients who were treated systemically after surgery. OS in pT1b (logrank test; p = 0.03) and DFS in pT1c (logrank test; p < 0.001) were significantly improved in treated compared with untreated patients. In the Cox proportional hazards model, treated patients had significantly longer OS than untreated patients in pT1b (hazard ratio (HR) 0.20) and pT1c (HR 0.54) groups. Estrogen receptor-negative tumors was also a significant predictor of survival in pT1c (HR 2.01) but not pT1ab patients. Furthermore, HR was greater in patients aged ≤ 35 years (3.18) compared to that in patients aged 50–69 years in the pT1b group. Conclusions: NCD data revealed that systemic treatment improved OS in pT1bc but not in pT1a node-negative HER2+ breast cancer patients. Future observational research using big-sized data is expected to play an important role in optimizing treatment for patients with early-stage breast cancer.

AB - Purpose: Recurrence risk management of patients with small (≤ 2 cm), node-negative, human epidermal growth factor receptor 2 (HER2)-positive breast cancer remains challenging. We studied the effects of adjuvant chemotherapy and/or trastuzumab and survival outcomes among these patients, using data from the population-based Japanese National Clinical Database (NCD). Methods: We identified a cohort of 2736 breast cancer patients with HER2+ pT1N0 disease: 489 pT1a, 642 pT1b, and 1623 pT1c. The median observation period was 76 months, and the 5-year follow-up rate was 48.2%. The number of events was 212 for disease-free survival (DFS), 40 for breast cancer-specific survival, and 84 for overall survival (OS). Results: There were 24.5% of pT1a, 51.9% of pT1b, and 63.3% of pT1c patients who were treated systemically after surgery. OS in pT1b (logrank test; p = 0.03) and DFS in pT1c (logrank test; p < 0.001) were significantly improved in treated compared with untreated patients. In the Cox proportional hazards model, treated patients had significantly longer OS than untreated patients in pT1b (hazard ratio (HR) 0.20) and pT1c (HR 0.54) groups. Estrogen receptor-negative tumors was also a significant predictor of survival in pT1c (HR 2.01) but not pT1ab patients. Furthermore, HR was greater in patients aged ≤ 35 years (3.18) compared to that in patients aged 50–69 years in the pT1b group. Conclusions: NCD data revealed that systemic treatment improved OS in pT1bc but not in pT1a node-negative HER2+ breast cancer patients. Future observational research using big-sized data is expected to play an important role in optimizing treatment for patients with early-stage breast cancer.

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