The efficacy of molecular subtyping in predicting postoperative recurrence in breast-conserving therapy: a 15-study meta-analysis

World Journal of Surgical Oncology

Shui Wang³  Hong-yong Cao¹  Chong-yin Tang²  Bin Zhang²  Mu-hong Guo²  Yang Xu⁴  Jia-yi Zhang⁴  Han-jin Wang²  Peng Jiang²  Jing Chen² 

[1] Department of General Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, China;Department of General Surgery of Breast and Thyroid, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, China;Department of Breast Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China;Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China

关键词: Meta-analysis;    Recurrence;    Breast-conserving therapy;    Molecular subtypes;    Breast cancer;   

Others  :  1148765
DOI  :  10.1186/1477-7819-12-212

 received in 2014-02-21, accepted in 2014-07-04,  发布年份 2014

【 摘 要 】

Background

Recent research displays that breast cancer (BC) is a heterogeneous disease and distinct molecular subtypes yield different prognostic outcomes.

Methods

We conducted a meta-analysis to clarify the role of molecular subtypes in recurrence risk after breast-conserving therapy (BCT). Eligible studies of single- (ER, PR, Her-2, and p53) and triple-molecular (Luminal A, Luminal B, Her-2, triple-negative) subtypes were identified through multiple search strategies. Pooled hazard ratios with 95% confidence intervals were calculated to assess this research topic.

Results

Fifteen studies involving 21,645 participants were included in the meta-analysis. Her-2 positive patients had a significantly higher recurrence risk in both overall merge (HR = 1.97, 95% CI: 1.41-2.75) and subtotal merge of local recurrence (LR) (HR = 1.93, 95% CI: 1.34-2.78). Significantly higher risk of recurrence was also observed in p53 positive patients by overall merge (HR = 1.78, 95% CI: 1.49 -2.12) and subtotal merge of LR (HR = 1.73, 95% CI: 1.44-2.07). When setting Luminal A as a baseline, Luminal B, Her-2, and triple-negative all showed significantly increased risk for both LR and distant recurrence (DR). Comparing triple-negative and non-triple-negative subtypes showed the biggest risk for overall recurrence (HR = 3.19, 95% CI: 1.91-5.31) and LR (HR = 3.31, 95% CI: 1.69-6.45).

Conclusions

Our meta-analysis showed significant differences in recurrence risk among various molecular subtypes after BCT. Although Her-2 and p53 positive subtypes can be considered independent prognostic biomarkers for indicating high LR risk, triple-molecular biomarkers showed higher clinical value. Triple-negative subtype showed the highest recurrence risk among all subtypes, and adjuvant chemotherapy should be considered for it.

【 授权许可】

   
2014 Chen et al.; licensee BioMed Central Ltd.

【 图 表 】

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