Hormon reseptörü negatif ve her-2 negatif meme kanserli hastalarla hormon reseptörü negatif ve her-2 pozitif meme kanserli hastaların demografik, patolojik ve klinik özelliklerinin karşılaştırılması
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Tarih
2008
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info:eu-repo/semantics/openAccess
Özet
Meme kanseri heterojen bir hastalıktır ve halen bazı alt gruplar kötü klinik seyre sahiptir. Bu retrospektif çalışmanın amacı hormon reseptör negatif hastalar arasında HER?2 pozitif ve negatif meme kanserli hastaların farklı demografik, patolojik ve klinik seyire sahip olup olmadığını araştırmaktır. Bin dokuz yüz doksan dokuz ve 2006 yılları arasında, hormon reseptör negatif meme kanserli hastalara içinde HER?2 durumu bilinen 91 hastanın demografik, patolojik, klinik özellikleri ve sağkalım sonuçları incelendi. Yaş, çocuk doğurma yaşı, çocuk sayısı, menopoz yaşı ve beden kitle oranı gibi demografik özellikler iki grup arasında farklı değilken, HER?2 negatif hastalar HER?2 pozitif hastalardan daha fazla meme kanserli aile öyküsüne sahipti (sırasıyla, %13.2' karşı 0%, p=0.091). Sadece 3 hastada tanı sırasında ileri evre hastalık vardı. Altı hasta cerrahiden sonra başka tedavi seçeneklerine onay vermedi. Toplam 83 hasta neoadjuvan (n:9) ve adjuvan (n:83) kemoterapi aldı. Kırk bir (%46.6) hastada yineleme gelişti. Tümör çapı, tutulmuş aksiller lenf nodu sayısı erken evre meme kanserli hastalar arsında yinelemeyle anlamlı ilişkiye sahipti. HER?2, tümör gradı, lenfovasküler invazyon, perinöral invazyon ve menopozal durum yineleme ile ilişkili bulunmadı. Tümör çapı (p=0.042) ve tutulmuş aksiller lenf nodu sayısı (p=0.001) hastalıksız sağkalım için bağımsız prognostik faktörlerdi, diğer faktörler prognostik faktör olarak bulunmadı. İleri evre HER 2 pozitif hastalarda daha sık beyin metastazı oluşmasına eğilim vardı (p=0.052). Taksanlara objektif yanıt HER?2 pozitif hastalarda daha düşük olma eğiliminde idi (p=0.071). Genel sağkalım için çok değişkenli analizde bağımsız prognostik faktör saptanmadı. Tek değişkenli analizde tutulmuş aksiller lenf nodu sayısı (p=0.004) ve HER?2 durumu (p=0.043) genel sağkalım üzerine etkili 44 faktörler olarak bulundu. Sonuç olarak, hormon reseptör negatif meme kanserli hastalardan HER?2 pozitif ve negatif hastalar arasında bazı farklar vardır. Bu grup hastalar farklı stratejilerle takip ve tedavi edilmelidir. HER 2 negatif hastalar rutin genetik danışmanlık almalıdır. HER 2 pozitif hastalar profilaktik kraniyal radyoterapi için aday olabilir. HER 2 pozitif hastalar en az HER 2 negatif hastalar kadar sistemik tedavilere dirençlidir. Her iki grubun yeni etkin tedavi stratejilerine ihtiyacı vardır.
Breast cancer is a heterogeneous disease and some subgroups have stili poor clinical coure. The aim of this retrospective study was to investigate whether HER-2 positive and negative patients among hormon receptor negative breast cancer patients have different demographic and pathologic features, and different clinical course. Demographics, pathologic and clinical features and survival results were reviewed in 91 hormon receptor negative breast cancer patients with known HER-2 status between 2001 and 2006. Sixty-eigth patients were HER-2 negative and 23 patients were HER-2 positive. While demograpfıcs such as age, childbearing-age, parity, menoposal age, body-massindex were not dififerent among groups, HER-2 negative patients have more family history with breast cancer than HER-2 positive patients (13.2% versus 0%, P = 0.091, respectively) Only three patients have advanced disease at diagnosis. Six patients did not give consent to other modalities after surgery. Totally 83 patients received neoadjuvant (n: 9) or adjuvant (n: 74) chemotherapy. Forty-one (46.6%) patients recurred. Tumor size and involved axillary lymph node number have a significant association with recurrence in early breast cancer patients (p=0.042 and p=0.001, respectively). HER-2, tumor grade, lymphovascular invasion, perineural invasion and menoposal status were not found associated with recurrence. involved 46 axillary lymph node number (p=0.04), but other factors were independent prognostic factors for disease-free survival. There was a trend for more brain metastasis in HER-2 positive patients than HER-2 negtive patients (p=0.052). There was a trend toward significantly low objective response to taxanes in HER-2 positive patients (p=0.071). independent prognostic factors were not obtained with multivariate analysis for overall survival; but involved axillary lymph node number (p=0.004) and HER status (p=0.043) were obtained as factors affecting on overall survivalin univariate analysis. In conclusion, there are some differences between HER-negative and HER positive breast cancer patients. These groups patients should be followed and treated with different strategies. ``Triple negative patients should be routinely received genetic counselling. HER-2 positive patients may be candidate for prophylactic cranial radiotherapy. HER-2 positive patients are at least as resistant as to systemic therapy in HER-2 negative patients. Both groups need to new effective therapy strategies.
Breast cancer is a heterogeneous disease and some subgroups have stili poor clinical coure. The aim of this retrospective study was to investigate whether HER-2 positive and negative patients among hormon receptor negative breast cancer patients have different demographic and pathologic features, and different clinical course. Demographics, pathologic and clinical features and survival results were reviewed in 91 hormon receptor negative breast cancer patients with known HER-2 status between 2001 and 2006. Sixty-eigth patients were HER-2 negative and 23 patients were HER-2 positive. While demograpfıcs such as age, childbearing-age, parity, menoposal age, body-massindex were not dififerent among groups, HER-2 negative patients have more family history with breast cancer than HER-2 positive patients (13.2% versus 0%, P = 0.091, respectively) Only three patients have advanced disease at diagnosis. Six patients did not give consent to other modalities after surgery. Totally 83 patients received neoadjuvant (n: 9) or adjuvant (n: 74) chemotherapy. Forty-one (46.6%) patients recurred. Tumor size and involved axillary lymph node number have a significant association with recurrence in early breast cancer patients (p=0.042 and p=0.001, respectively). HER-2, tumor grade, lymphovascular invasion, perineural invasion and menoposal status were not found associated with recurrence. involved 46 axillary lymph node number (p=0.04), but other factors were independent prognostic factors for disease-free survival. There was a trend for more brain metastasis in HER-2 positive patients than HER-2 negtive patients (p=0.052). There was a trend toward significantly low objective response to taxanes in HER-2 positive patients (p=0.071). independent prognostic factors were not obtained with multivariate analysis for overall survival; but involved axillary lymph node number (p=0.004) and HER status (p=0.043) were obtained as factors affecting on overall survivalin univariate analysis. In conclusion, there are some differences between HER-negative and HER positive breast cancer patients. These groups patients should be followed and treated with different strategies. ``Triple negative patients should be routinely received genetic counselling. HER-2 positive patients may be candidate for prophylactic cranial radiotherapy. HER-2 positive patients are at least as resistant as to systemic therapy in HER-2 negative patients. Both groups need to new effective therapy strategies.
Açıklama
Anahtar Kelimeler
Onkoloji, Oncology
