Factors-associated with short-term effect and long-term survival of ovarian function suppression in estrogen receptor positive breast cancer: a retrospective analysis

Yiming LIU; Lei FAN; Miao MO; Zhimin SHAO; Keda YU

doi:10.19401/j.cnki.1007-3639.2022.08.005

您当前的位置：

首页 >

文章列表页 >

Factors-associated with short-term effect and long-term survival of ovarian function suppression in estrogen receptor positive breast cancer: a retrospective analysis

Article | 更新时间：2025-12-31

- Factors-associated with short-term effect and long-term survival of ovarian function suppression in estrogen receptor positive breast cancer: a retrospective analysis
- China Oncology Vol. 32, Issue 8, Pages: 705-711(2022)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院乳腺外科,复旦大学上海医学院肿瘤学系,上海 200032
  2. 复旦大学附属肿瘤医院肿瘤预防部,复旦大学上海医学院肿瘤学系,上海 200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2022.08.005
  CLC： R737.9
- Received：29 April 2022，
  
  Revised：2022-06-22，
  
  Published：30 August 2022
- 稿件说明：
移动端阅览
Yiming LIU, Lei FAN, Miao MO, et al. Factors-associated with short-term effect and long-term survival of ovarian function suppression in estrogen receptor positive breast cancer: a retrospective analysis[J]. China Oncology, 2022, 32(8): 705-711.
DOI：

Yiming LIU, Lei FAN, Miao MO, et al. Factors-associated with short-term effect and long-term survival of ovarian function suppression in estrogen receptor positive breast cancer: a retrospective analysis[J]. China Oncology, 2022, 32(8): 705-711. DOI： 10.19401/j.cnki.1007-3639.2022.08.005.

摘要

背景与目的：

内分泌治疗已经是激素受体阳性乳腺癌患者手术后辅助治疗的常规手段之一。本研究旨在分析影响可手术乳腺癌患者接受卵巢功能抑制（ovarian function suppression

OFS）治疗后短期效应（雌激素抑制效果）和长期生存（无病生存期）的影响因素。

方法：

回顾性分析2017年6月

#x02014;2019年6月于复旦大学附属肿瘤医院行手术且完成术后标准化疗和内分泌治疗（OFS联合他莫昔芬或芳香化酶抑制剂）的435例雌激素受体（estrogen receptor

ER）阳性乳腺癌患者的临床病理学资料和无病生存期（disease-free survival

DFS）。采用单因素和多因素logistic回归分析对雌激素抑制效应有影响的因素

并运用log-rank检验和Cox比例风险回归模型分析对患者DFS有影响的因素。

结果：

OFS治疗后

年龄

#x02264;35岁患者雌激素抑制失败率为8.7%

显著高于35 ~ 40岁患者1%的雌激素抑制失败率（

0.05）;不同OFS药物如戈舍瑞林和亮丙瑞林的雌激素抑制作用基本一致（

0.05）。内分泌治疗方案（HR = 0.49

0.05）、腋窝淋巴结状态（HR = 4.21

0.05）和肿瘤直径（HR = 2.00

0.05）均是患者DFS的独立预后因素;虽然雌激素抑制失败患者倾向预后较差（

= 0.10）

但不同OFS药物对降低复发转移的疗效也一致。

结论：

年龄是乳腺癌患者采用OFS治疗后短期雌激素抑制失败的独立危险因素;内分泌药物、腋窝淋巴结状态以及肿瘤直径会影响ER阳性可手术乳腺癌患者的长期预后;无论是戈舍瑞林还是亮丙瑞林对患者降低雌激素水平和长期无病生存期差异无统计学意义。

Abstract

Background and purpose:

Endocrine therapy has been one of the routine means of adjuvant therapy for patients with hormone receptor positive after surgery. This study aimed to analyze the factors influencing short-term effect (estrogen suppression effect) and long-term survival (disease-free survival

DFS) in patients with operable breast cancer after ovarian function suppression (OFS) therapy.

Methods:

DFS data and clinicopathological parameters for 435 patients with estrogen receptor (ER) positive b

reast cancer who underwent surgery and completed postoperative standard chemotherapy and endocrine therapy (OFS combined with tamoxifen or aromatase inhibitors) between June 2017 to June 2019 were obtained in Fudan University Shanghai Cancer Center. The authors performed univariate logistic regression and multivariate logistic regression to analyze the influencing factors of estrogen suppression

while log-rank test and COX proportional hazards regression model were used to analyze the influencing factors of disease-free survival.

Results:

The failure rate of estrogen suppression in patients aged

#x02264;35 years was 8.7%

which was significantly higher than that in patients aged 35-40 years (1%

0.05). There was no difference in the level of estrogen decline between goserelin and leuprorelin (

0.05). Endocrine therapy regimen (HR = 0.49

0.05)

axillary lymph node status (HR = 4.21

0.05)

and tumor diameter (HR = 2.00

0.05) were all influencing factors of patients' DFS; The prognosis of patients with estrogen suppression failure was poor (

= 0.10)

but the efficacy of goserelin and leuprorelin in reducing recurrence and metastasis was consistent.

Conclusion:

Age is an independent risk factor for the failure of short-term estrogen suppression in breast cancer patients treated with OFS. Endocrine therapy regimen

axillary lymph node status and tumor diameter affect the long-term prognosis of patients with ER-positive operable breast cancer. There was no significant difference in the reduction of estrogen levels and long-term disease-free survival between patients with goserelin and leuprorelin.

关键词

Keywords

references

SUNG H , FERLAY J , SIEGEL R L , et al . Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2021 , 71 ( 3 ): 209 - 249 . DOI: 10.3322/caac.21660 http://doi.org/10.3322/caac.21660 https://onlinelibrary.wiley.com/doi/10.3322/caac.21660 https://onlinelibrary.wiley.com/doi/10.3322/caac.21660

DESANTIS C E , MA J M , GAUDET M M , et al . Breast cancer statistics, 2019 [J ] . CA A Cancer J Clin , 2019 , 69 ( 6 ): 438 - 451 . DOI: 10.3322/caac.21583 http://doi.org/10.3322/caac.21583 https://onlinelibrary.wiley.com/doi/abs/10.3322/caac.21583 https://onlinelibrary.wiley.com/doi/abs/10.3322/caac.21583

中国抗癌协会乳腺癌专业委员会 . 中国抗癌协会乳腺癌诊治指南与规范(2021年版) [J ] . 中国癌症杂志 , 2021 , 31 ( 10 ): 954 - 1040 .

The Society of Breast Cancer China Anti-Cancer Association . Guidelines for breast cancer diagnosis and treatment by China Anti-Cancer Association (2021 edition) [J ] . China Oncol , 2021 , 31 ( 10 ): 954 - 1040 .

HUERTA-REYES M , MAYA-NÚÑEZ G , PÉREZ-SOLIS M A , et al . Treatment of breast cancer with gonadotropin-releasing hormone analogs [J ] . Front Oncol , 2019 , 9 : 943 . DOI: 10.3389/fonc.2019.00943 http://doi.org/10.3389/fonc.2019.00943 https://www.frontiersin.org/article/10.3389/fonc.2019.00943/full https://www.frontiersin.org/article/10.3389/fonc.2019.00943/full

LU Y S , WONG A , KIM H J . Ovarian function suppression with luteinizing hormone-releasing hormone agonists for the treatment of hormone receptor-positive early breast cancer in premenopausal women [J ] . Front Oncol , 2021 , 11 : 700722 . DOI: 10.3389/fonc.2021.700722 http://doi.org/10.3389/fonc.2021.700722 https://www.frontiersin.org/articles/10.3389/fonc.2021.700722/full https://www.frontiersin.org/articles/10.3389/fonc.2021.700722/full

DAVIDSON N E , O'NEILL A M , VUKOV A M , et al . Chemoendocrine therapy for premenopausal women with axillary lymph node-positive, steroid hormone receptor-positive breast cancer: results from INT 0101 (E5188) [J ] . J Clin Oncol , 2005 , 23 ( 25 ): 5973 - 5982 . DOI: 10.1200/JCO.2005.05.551 http://doi.org/10.1200/JCO.2005.05.551 https://ascopubs.org/doi/10.1200/JCO.2005.05.551 https://ascopubs.org/doi/10.1200/JCO.2005.05.551

FRANCIS P A , PAGANI O , FLEMING G F , et al . Tailoring adjuvant endocrine therapy for premenopausal breast cancer [J ] . N Engl J Med , 2018 , 379 ( 2 ): 122 - 137 . DOI: 10.1056/NEJMoa1803164 http://doi.org/10.1056/NEJMoa1803164 http://www.nejm.org/doi/10.1056/NEJMoa1803164 http://www.nejm.org/doi/10.1056/NEJMoa1803164

KIM H A , LEE J W , NAM S J , et al . Adding ovarian suppression to tamoxifen for premenopausal breast cancer: a randomized phase Ⅲ trial [J ] . J Clin Oncol , 2020 , 38 ( 5 ): 434 - 443 .

MASUDA N , SAGARA Y , KINOSHITA T , et al . Neoadjuvant anastrozole versus tamoxifen in patients receiving goserelin for premenopausal breast cancer (STAGE): a double-blind, randomised phase 3 trial [J ] . Lancet Oncol , 2012 , 13 ( 4 ): 345 - 352 . DOI: 10.1016/S1470-2045(11)70373-4 http://doi.org/10.1016/S1470-2045(11)70373-4 https://linkinghub.elsevier.com/retrieve/pii/S1470204511703734 https://linkinghub.elsevier.com/retrieve/pii/S1470204511703734

GNANT M , MLINERITSCH B , STOEGER H , et al . Zoledronic acid combined with adjuvant endocrine therapy of tamoxifen versus anastrozol plus ovarian function suppression in premenopausal early breast cancer: final analysis of the Austrian breast and colorectal cancer study group trial 12 [J ] . Ann Oncol , 2015 , 26 ( 2 ): 313 - 320 . DOI: 10.1093/annonc/mdu544 http://doi.org/10.1093/annonc/mdu544 https://linkinghub.elsevier.com/retrieve/pii/S0923753419313912 https://linkinghub.elsevier.com/retrieve/pii/S0923753419313912

PERRONE F , DE LAURENTIIS M , DE PLACIDO S , et al . Adjuvant zoledronic acid and letrozole plus ovarian function suppression in premenopausal breast cancer: HOBOE phase 3 randomised trial [J ] . Eur J Cancer , 2019 , 118 : 178 - 186 . DOI: 10.1016/j.ejca.2019.05.004 http://doi.org/10.1016/j.ejca.2019.05.004 https://linkinghub.elsevier.com/retrieve/pii/S0959804919302977 https://linkinghub.elsevier.com/retrieve/pii/S0959804919302977

BELLET M , GRAY K P , FRANCIS P A , et al . Twelve-month estrogen levels in premenopausal women with hormone receptor-positive breast cancer receiving adjuvant triptorelin plus exemestane or tamoxifen in the suppression of ovarian function trial (SOFT): the SOFT-EST substudy [J ] . J Clin Oncol , 2016 , 34 ( 14 ): 1584 - 1593 . DOI: 10.1200/JCO.2015.61.2259 http://doi.org/10.1200/JCO.2015.61.2259 https://ascopubs.org/doi/10.1200/JCO.2015.61.2259 https://ascopubs.org/doi/10.1200/JCO.2015.61.2259

ALLISON K H , HAMMOND M E H , DOWSETT M , et al . Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update [J ] . J Clin Oncol , 2020 , 38 ( 12 ): 1346 - 1366 . DOI: 10.1200/JCO.19.02309 http://doi.org/10.1200/JCO.19.02309 https://ascopubs.org/doi/10.1200/JCO.19.02309 https://ascopubs.org/doi/10.1200/JCO.19.02309

WOLFF A C , HAMMOND M E H , ALLISON K H , et al . Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline focused update [J ] . J Clin Oncol , 2018 , 36 ( 20 ): 2105 - 2122 .

HOSMER JR D W , LEMESHOW S , STURDIVANT R X . Applied logistic regression [M ] . John Wiley & Sons , 2013 .

CHOWDHURY M Z I , TURIN T C . Variable selection strategies and its importance in clinical prediction modelling [J ] . Fam Med Community Health , 2020 , 8 ( 1 ): e000262.

Views

2535

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Clinical consideration of two key questions in assessing menopausal status of female breast cancer patients

Expert consensus on clinical applications of ovarian function suppression for Chinese women with early breast cancer (2024 edition)

Expert consensus on clinical applications of ovarian function suppression for Chinese women with early breast cancer 2021 CACA-CBCS

中国早期乳腺癌卵巢功能抑制临床应用专家共识(2016年版)

Guidelines for breast cancer diagnosis and treatment by China Anti-Cancer Association (2026 edition)

Related Author

Jian ZHANG

China Anti-Cancer Association Committee of Breast Cancer Society,

Committee of Breast Cancer Society Chinese Anti-Cancer Association,

徐兵河

邵志敏

胡夕春

The Society of Breast Cancer China Anti-Cancer Association

Breast Oncology Group of the Oncology Branch of the Chinese Medical Association

Related Institution

Department of Medical Oncology, Fudan University Shanghai Cancer Center; Phase Ⅰ Clinical Trial Center, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University

中国医学科学院肿瘤医院肿瘤内科

复旦大学附属肿瘤医院乳腺外科，复旦大学上海医学院肿瘤学系

复旦大学附属肿瘤医院肿瘤内科，复旦大学上海医学院肿瘤学系

Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

AI问答

⁰