Erken Evre Triple Negatif Meme Kanserinde Sağkalım Sonuçları ve Prognostik Faktörler: Tek Merkez Deneyimi

Year 2023, Volume: 49 Issue: 3, 355 - 360, 31.12.2023

Yasin Kutlu , Sabin Goktas Aydın , Ahmet Bilici , Ömer Ölmez , Ozgur Acikgoz , Jamshid Hamdard , Özcan Yıldız , Ebru Karcı , Harun Muğlu

https://doi.org/10.32708/uutfd.1356458

Abstract

Çalışmamız, erken evre triple negatif meme kanseri (TNMK) hastalarının sonuçlarını etkileyen faktörleri araştırmayı amaçlamaktadır. 2012-2022 yılları arasında Medipol Üniversitesi Tıp Fakültesi Tıbbi Onkoloji kliniğine başvuran 101 TNMK hastasının verileri retrospektif olarak analiz edildi. Hastaların yaş, menopoz durumu, tedavi rejimleri, klinik ve patolojik evreleri, cerrahi müdahaleleri, yardımcı tedavileri ve genetik mutasyonları gibi özellikleri kaydedildi. Patolojik tam yanıt (pCR), neoadjuvan tedavi(NAT) sonrası patolojide kanser hücrelerinin bulunmaması olarak tanımlandı. Medyan yaş 45.3 yıldı, 55 hasta premenopoz ve 46 hasta postmenopoz idi. Hastaların çoğunda (%70.3) T2 tümörü vardı, hastaların %35.6'sı klinik evre N0, %52.5'i ise N1'di. Hastaların %63.4' üne NAT, %36.6'sına adjuvan tedavi uygulandı. NAT alan hastaların %32.8'inde pCR elde edildi. T evresi, N evresi, doz yoğun kemoterapi, NAT'e karboplatin eklenmesi ve BRCA mutasyon durumu gibi faktörler, pCR elde edilen hastalar ile edilmeyen hastalar arasında anlamlı bir fark göstermedi. Yüksek ki-67 ifadesi, daha yüksek pCR oranları ile ilişkilendirildi. 24 aylık hastalıksız sağkalım(DFS) ve genel sağkalım(OS) oranları sırasıyla %78.5 ve %83.6 idi. Adjuvan kapesitabin kullanımı, menopoz durumu, düşük ki-67 ifadesi ve pCR elde etme gibi faktörler, daha uzun DFS ile ilişkilendirildi. Çoklu değişken analizinde, başlangıç N evresi ve pCR elde etme, DFS için bağımsız prognostik faktörlerdi. OS için başlangıç N evresi ve pCR durumu anlamlı prognostik faktörlerdi. Bu çalışma, erken evre TNMK'de pCR elde etmenin önemini ve adjuvan kapesitabinin DFS faydalarını vurgulamaktadır.

Keywords

meme kanseri, neoadjuvan tedavi, ki-67

Ethical Statement

Çalışma, İstanbul Medipol Üniversitesi etik kurulu tarafından onaylanmıştır.

Outcomes and Prognostic Factors in Early-Stage Triple Negative Breast Cancer: Single-Center Experience

Abstract

This study aims to investigate factors influencing the outcomes of early-stage triple negative breast cancer (TNBC) patients.We conducted a retrospective analysis of 101 early-stage TNBC patients at Medipol University Faculty of Medicine from 2012 to 2022. Patient characteristics, including age, menopausal status, treatment regimens, clinical and pathological stages, surgical interventions, adjuvant therapies, and genetic mutations, were considered. We defined pathological complete response (pCR) as the absence of residual cancer cells following neoadjuvant treatment(NAT).The median age was 45.3 years, 55 of them were premenopausal, and 46 were postmenopausal. Most patients (70.3%) had T2 tumors, and 35.6% had N0 clinical lymph node status, while 52.5% had N1. NAT was administered to 63.4% of patients, and adjuvant treatment to 36.6%. Among the patients who received NAT, 32.8% achieved a pCR. Factors such as T stage, N stage, dose-dense chemotherapy, addition of carboplatin to NAT, and BRCA mutation status showed no significant difference between patients achieving pCR and those who did not. High Ki-67 expression was associated with higher pCR rates. The 24-month disease-free survival(DFS) and overall survival(OS) rates were 78.5% and 83.6%, respectively. Factors such as adjuvant capecitabine use, menopausal status, low ki-67 expression, and achieving pCR were associated with longer DFS. On multivariate analysis, the initial N stage and achieving pCR were independent prognostic factors for DFS. For OS, initial N stage and pCR status were significant prognostic factors.This study highlights the significance of achieving pCR in early-stage TNBC and the DFS benefits of adjuvant capecitabine.

Keywords

breast cancer, neoadjuvant treatment, ki-67

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