Can chemotherapy be omitted for patients with N0 or N1 endocrine-sensitive breast cancer treated with gonadotropin-releasing hormone agonist and tamoxifen?

Juhyeon Lee; Chan Sub Park; Jeong Hun Oh; In-Chul Park; Min-Ki Seong; Woo Chul Noh; Hyun-Ah Kim

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자료유형: 학술저널

저자정보: Juhyeon Lee (Korea Institute of Radiological and Medical Sciences) Chan Sub Park (Korea Institute of Radiological and Medical Sciences) Jeong Hun Oh (Korea Institute of Radiological and Medical Sciences) In-Chul Park (Korea Institute of Radiological and Medical Sciences) Min-Ki Seong (Korea Institute of Radiological and Medical Sciences) Woo Chul Noh (Konkuk University Medical Center) Hyun-Ah Kim (Korea Institute of Radiological and Medical Sciences)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.105 No.1

발행연도: 2023.7

수록면: 31 - 36 (6page)

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Purpose: Whether administering chemotherapy followed by tamoxifen plus a gonadotropin-releasing hormone (GnRH) agonist to treat patients with lower-risk hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer provides a greater benefit than administering tamoxifen plus GnRH agonist alone remains unclear. This study aimed to compare the outcomes of propensity score-matched (PSM) patients who underwent these 2 types of treatment plans.
Methods: This retrospective study included patients treated at our institution between 2009 and 2019. Eligible patients had HR-positive, HER2-negative, invasive breast cancer who had undergone surgery. There were 579 patients with HR-positive, HER2-negative breast cancer who were treated with a GnRH agonist and tamoxifen; patients with pathologic N2 and those who received neoadjuvant chemotherapy were excluded. After 1:1 PSM of patients who underwent GnRH agonist treatment and tamoxifen with versus without chemotherapy, 122 patients from these 2 groups were analyzed. Survival rates were calculated using the Kaplan-Meier method and compared via the log-rank test.
Results: After PSM, there were no significant differences in several baseline characteristics between the 2 groups. After a median follow-up of 62.8 months, the patients in both groups demonstrated similar outcomes with no significant difference in disease-free survival (P = 0.596).
Conclusion: Patients derived no significant survival benefit from undergoing a chemotherapy regimen before receiving tamoxifen and GnRH agonist therapy compared to forgoing such chemotherapy.

#Adjuvant chemotherapy #Breast neoplasms #Gonadotropin-releasing hormone #Propensity score #Tamoxifen

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