Analysis on complete pathological response and estimated survival among breast cancer patients undergoing neoadjuvant chemotherapy in a private institution in the state of Rio de Janeiro

ABSTRACT

Objective: Breast cancer is the most common malignancy among women, both in developed and in developing countries. Indications for neoadjuvant treatment have been expanded so that pathological responses can be evaluated. Diversified therapeutic approaches may thus be indicated in accordance with each residual disease profile. This was a real-life study, in which the aim was to analyze the complete pathological response (CPR) and estimated survival among breast cancer patients undergoing neoadjuvant chemotherapy in a private institution in the state of Rio de Janeiro.

Methods: This was a prospective observational cohort study on patients diagnosed with breast cancer and treated with neoadjuvant chemotherapy, in a private institution. The primary objective of this study was to analyze CPR. As secondary endpoints, we evaluated the disease-free survival (DFS) and overall survival (OS) of these patients and correlated them with clinical-pathological variables.

Results: CPR was achieved in: 12.5% of luminal A cases; 19.5% of luminal B/HER-2-negative cases; 38.5% of luminal B/ HER-2-positive cases; 65% of HER-2-enriched cases; and 37.8% of triple negative cases. There was a significant correlation between CPR and histopathological subtypes (p<0.001). At the end of 36 months, the DFS for patients with CPR was 89.1% vs. 72.4% for the others (p=0.01). OS could not be calculated for patients who achieved CPR, because there was no event.

Conclusion: We confirmed in this study that a correlation exists between CPR and overall survival. In addition, we were able to show that even in developing countries, such as Brazil, appropriate treatments can be offered in accordance with international guidelines, such that our results were consequently similar to those in the worldwide literature.

RESUMO

Objetivo: O câncer de mama é a neoplasia maligna mais comum entre as mulheres, tanto em países desenvolvidos quanto em desenvolvimento. As indicações para o tratamento neoadjuvante foram expandidas para que as respostas patológicas possam ser avaliadas. Abordagens terapêuticas diversificadas podem, portanto, ser indicadas de acordo com o perfil de cada doença residual. Trata-se de um estudo da vida real, cujo objetivo foi analisar a resposta patológica completa (RCP) e a estimativa de sobrevida em pacientes com câncer de mama em quimioterapia neoadjuvante em uma instituição privada do estado do Rio de Janeiro.

Métodos: Estudo de coorte prospectivo observacional em pacientes com diagnóstico de câncer de mama e tratamento com quimioterapia neoadjuvante, em instituição privada. O objetivo principal deste estudo foi analisar a RCP. Como desfechos secundários, avaliamos a sobrevida livre de doença (SLD) e a sobrevida geral (SG) desses pacientes e as correlacionamos com as variáveis clínico-patológicas.

Resultados: A RCP foi alcançada em: 12,5% dos casos luminal A; 19,5% dos casos luminais B/HER-2 negativos; 38,5% dos casos luminais B/HER-2 positivos; 65% dos casos enriquecidos com HER-2; e 37,8% de casos triplo negativos. Houve uma correlação significativa entre a RCP e os subtipos histopatológicos (p<0,001). Ao final de 36 meses, a DFS para pacientes com RCP foi de 89,1% vs. 72,4% para os demais (p=0,01). SG não pôde ser calculado para pacientes que alcançaram RCP, porque não houve nenhum evento.

Conclusão: Confirmamos neste estudo que existe uma correlação entre a RCP e a sobrevida global. Além disso, pudemos mostrar que mesmo em países em desenvolvimento, como o Brasil, tratamentos adequados podem ser oferecidos de acordo com as diretrizes internacionais, de forma que nossos resultados foram, consequentemente, semelhantes aos da literatura mundial.

Keywords:

Neoadjuvant therapy - Breast neoplasms - Pathology - Surgical - Neoplasm - Residual.

Descritores:

Terapia neoadjuvante - Neoplasias mamárias - Patologia Cirúrgica - Neoplasia residual.

Publikationsverlauf

Eingereicht: 15. Juni 2021

Angenommen: 19. August 2021

Artikel online veröffentlicht:
17. September 2021

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