학술논문
Correlation between postoperative treatment selection and prognosis determined using the Oncotype DX® test data: a retrospective multicenter study in Japan.
Document Type
Academic Journal
Author
Tsuchida Y; Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan.; Niikura N; Department of Breast Oncology, Tokai University School of Medicine, Kanagawa, Japan.; Chishima T; Department of Breast Surgery, Yokohama Rosai Hospital, Kanagawa, Japan.; Division of Breast Surgical Oncology, Department of Surgery, Showa University Northern Yokohama Hospital, Kanagawa, Japan.; Mizuno M; Department of Breast Oncology, Tokai University School of Medicine, Kanagawa, Japan.; Kawate T; Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan.; Fuchikami H; Department of Breast Oncology, Tokyo-West Tokushukai Hospital, Tokyo, Japan.; Miyoshi Y; Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan.; Sakai T; Department of Breast Oncology Center, Cancer Institute Hospital of JFCR, Tokyo, Japan.; Kotani H; Department of Breast Oncology, Aichi Cancer Center Hospital, Aichi, Japan.; Kondo N; Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.; Hayashi N; Division of Breast Surgical Oncology, Department of Surgery, Showa University School of Medicine, 1-5-8, Hatanodai, Shinahawa-ku, Tokyo, 142-8666, Japan. naokiha@med.showa-u.ac.jp.
Source
Publisher: Maruzen Co Country of Publication: Japan NLM ID: 100888201 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1880-4233 (Electronic) Linking ISSN: 13406868 NLM ISO Abbreviation: Breast Cancer Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: Oncotype DX® is a frequently used multigene assay for hormone receptor-positive breast cancers. However, limited evidence is available regarding its application in Japan owing to the lack of insurance coverage. Therefore, we conducted this large-scale, retrospective study by collecting data from nine Japanese institutes and assessed postoperative treatment choice and prognosis by using Oncotype DX®.
Methods: Six hundred thirty-two patients who underwent breast surgery and whose recurrence score (RS) data were available were included. They were divided into RS 0-25 and RS ≥ 26 groups. The groups were compared in terms of clinicopathological factors, treatment options, and prognosis.
Results: After the median follow-up period of 10.1 years, the disease-free survival (DFS) rates were significantly better in the RS 0-25 group (p = 0.02). Per the recurrent event type, there was no significant intergroup difference in locoregional recurrence (p = 0.139). However, a trend toward better distant DFS was observed in the RS 0-25 group (p = 0.08). Overall survival was also significantly better in this group (p = 0.027). Considering chemotherapy use, DFS worsened among chemotherapy-treated patients with an RS of 0-25 and those with an RS ≥ 26 who did not receive chemotherapy (p < 0.001). Seven (1.35%) chemotherapy-treated patients with an RS of 0-25 showed disease recurrence.
Conclusions: This study presents the largest database-derived prognostic data in Japanese patients, utilizing the Oncotype DX® treatment selection. Further studies are needed to determine the impact on treatment choice, considering the clinical risk, and the need for additional postoperative treatment.
(© 2024. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.)
Methods: Six hundred thirty-two patients who underwent breast surgery and whose recurrence score (RS) data were available were included. They were divided into RS 0-25 and RS ≥ 26 groups. The groups were compared in terms of clinicopathological factors, treatment options, and prognosis.
Results: After the median follow-up period of 10.1 years, the disease-free survival (DFS) rates were significantly better in the RS 0-25 group (p = 0.02). Per the recurrent event type, there was no significant intergroup difference in locoregional recurrence (p = 0.139). However, a trend toward better distant DFS was observed in the RS 0-25 group (p = 0.08). Overall survival was also significantly better in this group (p = 0.027). Considering chemotherapy use, DFS worsened among chemotherapy-treated patients with an RS of 0-25 and those with an RS ≥ 26 who did not receive chemotherapy (p < 0.001). Seven (1.35%) chemotherapy-treated patients with an RS of 0-25 showed disease recurrence.
Conclusions: This study presents the largest database-derived prognostic data in Japanese patients, utilizing the Oncotype DX® treatment selection. Further studies are needed to determine the impact on treatment choice, considering the clinical risk, and the need for additional postoperative treatment.
(© 2024. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.)