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

World Journal of Surgical Oncology

Research

Shui Wang¹  Chong-yin Tang²  Bin Zhang²  Peng Jiang²  Mu-hong Guo²  Han-jin Wang²  Jing Chen²  Hong-yong Cao³  Yang Xu⁴  Jia-yi Zhang⁴ 

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

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

DOI  :  10.1186/1477-7819-12-212

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

来源: Springer

【 摘 要 】

BackgroundRecent research displays that breast cancer (BC) is a heterogeneous disease and distinct molecular subtypes yield different prognostic outcomes.MethodsWe 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.ResultsFifteen 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).ConclusionsOur 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】

Unknown   
© Chen et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.