Prognostic factors affecting survival in early-stage HER2-positive breast cancer treated with adjuvant therapy

Abstract

Abstract Purpose: This study aimed to identify the prognostic and predictive factors affecting survival in patients with early-stage human epidermal growth factor receptor 2 (HER2) positive breast cancer who received adjuvant treatment. Materials and methods: A retrospective analysis was conducted on 124 female patients diagnosed with early-stage HER2-positive breast cancer at Pamukkale University Faculty of Medicine between January 2014 and December 2019. Clinicopathological characteristics, treatment regimens, and laboratory findings were analyzed. Survival analyses were performed using the Kaplan-Meier method, and factors influencing survival were evaluated using Cox regression analysis. Results: The mean follow-up duration were 63.9 months. The mean overall survival and progression-free survival were 65.1 and 58.8 months, respectively. Lymph node involvement greater than three, elevated Cancer Antigen 15-3 (CA15-3) (>25 U/mL), and high lactate dehydrogenase (LDH) levels (>214 U/L) were significantly associated with shorter progression-free survival (p<0.05). High CA15-3 levels were also correlated with decreased overall survival (p<0.05). Other parameters, including age, tumour size, Ki67 index, histologic and nuclear grade, lymphovascular invasion, chemotherapy regimen, and neutrophil-to-lymphocyte ratio (NLR), were not significantly related to survival outcomes. Conclusion: CA15-3 and LDH levels, along with the number of involved lymph nodes, were identified as potential prognostic indicators of early-stage HER2-positive breast cancer. These biomarkers may help guide clinical decision-making and patient follow-up. Further large-scale studies are required to validate these findings

Keywords

• HER2-positive breast cancer
• early stage
• lymph node
• CA15-3
• LDH

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors declare that they received no financial support for the research, authorship, and/or publication of this article.

Ethical Statement

Ethical approval for this study was obtained from the Pamukkale University Faculty of Medicine Non-Interventional Clinical Research Ethics Committee (approval date: January 7, 2020; approval number: 01). The study was conducted in accordance with the principles of the Declaration of Helsinki. All data were evaluated retrospectively, and patient confidentiality was maintained.

Adjuvan tedavi verilen erken evre HER2 pozitif meme kanserli hastalarda sağkalıma etki eden faktörler

Abstract

Öz Amaç: Bu çalışmanın amacı, adjuvan tedavi alan erken evre insan epidermal büyüme faktörü reseptörü 2 (HER2) pozitif meme kanserli hastalarda sağkalımı etkileyen prognostik ve prediktif faktörleri belirlemektir. Gereç ve yöntem: Pamukkale Üniversitesi Tıp Fakültesi’nde Ocak 2014–Aralık 2019 tarihleri arasında erken evre HER2 pozitif meme kanseri tanısı alan 124 kadın hastanın verileri retrospektif olarak incelendi. Klinikopatolojik özellikler, tedavi rejimleri ve laboratuvar bulguları analiz edildi. Sağkalım analizleri Kaplan-Meier yöntemiyle, sağkalımı etkileyen faktörler ise Cox regresyon analizi ile değerlendirildi. Bulgular: Ortalama takip süresi 63,9 ay idi. Ortalama genel sağkalım 65,1 ay, progresyonsuz sağkalım 58,8 ay olarak bulundu. Üçten fazla lenf nodu tutulumu, yüksek kanser antijen 15-3 (CA15-3) (>25 U/mL) ve yüksek laktat dehidrogenaz (LDH) düzeyi (>214 U/L) progresyonsuz sağkalımı anlamlı olarak kısaltmaktaydı (p<0,05). Ayrıca yüksek CA15-3 düzeyi, genel sağkalımın da azalmasıyla ilişkili bulundu (p<0,05). Yaş, tümör boyutu, Ki67, histolojik ve nükleer grade, lenfovasküler invazyon, kemoterapi rejimi ve nötrofil/lenfosit oranı (NLR) ile sağkalım arasında anlamlı ilişki saptanmadı. Sonuç: CA15-3 ve LDH düzeyleri ile lenf nodu sayısı, erken evre HER2 pozitif meme kanserli hastalarda potansiyel prognostik göstergeler olarak belirlenmiştir. Bu biyobelirteçler, tedavi planlaması ve hasta takibinde klinisyenlere yol gösterici olabilir. Bulguların doğrulanması için daha geniş kapsamlı çalışmalara ihtiyaç vardır.

Keywords

• HER2 pozitif meme kanseri
• erken evre
• lenf nodu
• LDH
• CA15-3

Supporting Institution

Bu çalışma, herhangi bir kurum, kuruluş veya fon tarafından maddi olarak desteklenmemiştir. Yazarlar, araştırma, yazarlık ve/veya makalenin yayımlanması sürecinde hiçbir finansal destek almadıklarını beyan ederler.

Ethical Statement

Bu çalışma için Pamukkale Üniversitesi Tıp Fakültesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan 07.01.2020 tarihli ve 01 sayılı onay alınmıştır. Çalışma, Helsinki Bildirgesi ilkelerine uygun olarak gerçekleştirilmiştir. Tüm veriler retrospektif olarak değerlendirilmiş olup, hasta gizliliği korunmuştur.

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