1. Correlation between postoperative treatment selection and prognosis determined using the Oncotype DX® test data: a retrospective multicenter study in Japan.
- Author
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Tsuchida Y, Niikura N, Chishima T, Mizuno M, Kawate T, Fuchikami H, Miyoshi Y, Sakai T, Kotani H, Kondo N, and Hayashi N
- Subjects
- Humans, Female, Middle Aged, Retrospective Studies, Japan epidemiology, Aged, Adult, Prognosis, Disease-Free Survival, Mastectomy, Chemotherapy, Adjuvant methods, Follow-Up Studies, Receptors, Estrogen metabolism, Receptors, Estrogen analysis, Gene Expression Profiling methods, Aged, 80 and over, Biomarkers, Tumor genetics, Receptor, ErbB-2 metabolism, Receptors, Progesterone metabolism, Breast Neoplasms surgery, Breast Neoplasms genetics, Breast Neoplasms pathology, Breast Neoplasms mortality, Breast Neoplasms drug therapy, Breast Neoplasms therapy, Neoplasm Recurrence, Local genetics, Neoplasm Recurrence, Local pathology
- Abstract
Purpose: Oncotype DX® is a frequently used multigene assay for hormone receptor-positive breast cancers. However, limited evidence is available regarding its application in Japan owing to the lack of insurance coverage. Therefore, we conducted this large-scale, retrospective study by collecting data from nine Japanese institutes and assessed postoperative treatment choice and prognosis by using Oncotype DX®., Methods: Six hundred thirty-two patients who underwent breast surgery and whose recurrence score (RS) data were available were included. They were divided into RS 0-25 and RS ≥ 26 groups. The groups were compared in terms of clinicopathological factors, treatment options, and prognosis., Results: After the median follow-up period of 10.1 years, the disease-free survival (DFS) rates were significantly better in the RS 0-25 group (p = 0.02). Per the recurrent event type, there was no significant intergroup difference in locoregional recurrence (p = 0.139). However, a trend toward better distant DFS was observed in the RS 0-25 group (p = 0.08). Overall survival was also significantly better in this group (p = 0.027). Considering chemotherapy use, DFS worsened among chemotherapy-treated patients with an RS of 0-25 and those with an RS ≥ 26 who did not receive chemotherapy (p < 0.001). Seven (1.35%) chemotherapy-treated patients with an RS of 0-25 showed disease recurrence., Conclusions: This study presents the largest database-derived prognostic data in Japanese patients, utilizing the Oncotype DX® treatment selection. Further studies are needed to determine the impact on treatment choice, considering the clinical risk, and the need for additional postoperative treatment., (© 2024. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.)
- Published
- 2024
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