Tianjin Med J ›› 2019, Vol. 47 ›› Issue (4): 409-413.doi: 10.11958/20182100

• Clinical Study • Previous Articles     Next Articles

The effect of postoperative chemotherapy on the prognosis of patients with stage ⅡA - ⅢB breast cancer without pCR after the complete cycle of neoadjuvant chemotherapy

LIU Mei, ZHANG Min, ZHI Xiang-cheng   

  1. The Third Department Breast Cancer, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Breast Cancer Prevention and Treatment (Ministry of Education); Key Laboratory of Cancer Prevention and Treatment, Tianjin; Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
  • Received:2018-12-20 Revised:2019-02-24 Published:2019-04-15 Online:2019-05-27
  • Contact: mei liu E-mail:liumei77916@163.com

Abstract: Objective To investigate the effect of postoperative chemotherapy on the prognosis of patients with stage ⅡA-ⅢB breast cancer who did not receive pathological complete response (pCR) after the complete cycle of neoadjuvant chemotherapy. Methods Clinical data of 208 breast cancer patients with stage Ⅱ A - Ⅲ B and without pCR after the complete cycle of neoadjuvant chemotherapy were retrospectively analyzed, including 81 patients underwent postoperative chemotherapy (supplemented chemotherapy group) and 127 patients without supplemental chemotherapy (no supplemented chemotherapy group). The 3-year overall survival rate, 3-year disease-free survival rate and factors affecting recurrence and metastasis were analyzed in two groups of patients. Results With a median follow-up of 40 months, the disease-free survival rate was 76.9% (160/208), and the 3-year overall survival rate was 88.9% (185/208) in whole group. The diseasefree survival rate was improved in supplemental chemotherapy group than that of no supplemented chemotherapy group (87.7% vs. 72.4%, P<0.05). There was no significant difference in the 3-year overall survival rate between supplemental chemotherapy group and the no supplemented chemotherapy group (94.2% and 92.1%, respectively, P>0.05). Univariate analysis showed that estrogen receptor (ER) status, pregnancy hormone receptor (PR) status, human epidermal growth factor receptor 2 (HER-2) status and postoperative adjuvant chemotherapy were the influencing factors for disease-free survival (P<0.05). Multivariate analysis showed that no postoperative chemotherapy (HR=2.044, P=0.033) and HER-2 positive (HR=3.418, P<0.001) were independent risk factors affecting the poor prognosis of patients with disease-free survival. Conclusion Postoperative chemotherapy can improve the disease-free survival rate of patients with stage ⅡA-ⅢB breast cancer who have not received pCR after the complete cycle of neoadjuvant chemotherapy. The prognosis of patients with positive HER-2 is even worse.

Key words: breast neoplasms, chemotherapy, adjuvant, prognosis, prognostic factors, supplemental chemotherapy