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Chinese Journal of Breast Disease(Electronic Edition) ›› 2018, Vol. 12 ›› Issue (01): 37-42. doi: 10.3877/cma.j.issn.1674-0807.2018.01.008

Special Issue:

• Original Article • Previous Articles     Next Articles

Extended adjuvant endocrine therapy vs five-year standard treatment for estrogen receptor-positive early breast cancer: a meta-analysis on patient prognosis

Fengli Yue1, Qinwen Pan2, Changrong Deng1,()   

  1. 1. Department of Emergency, Red Cross Hospital of Chongqing/People's Hospital of Jiangbei District, Chongqing 400020, China
    2. Department of Breast Surgery, Southwest Hospital, Army Military Medical University, Chongqing 400038, China
  • Received:2017-07-13 Online:2018-02-01 Published:2018-02-01
  • Contact: Changrong Deng
  • About author:
    Corresponding author: Deng Changrong, Email:

Abstract:

Objective

To evaluate the efficacy of extended adjuvant endocrine therapy for over 5 years in early breast cancer patients with estrogen receptor positive.

Methods

The related clinical controlled trials in literature on the efficacy comparison between standard endocrine therapy and extended adjuvant endocrine therapy were retrieved from the databases of Pubmed, Cochrane, Medline, Embase, China National Knowledge Infrastructure (CNKI) and WanFang. The screening was independently performed by two researchers according to the inclusion and exclusion criteria. The overall survival, disease-free survival, breast cancer-specific survival and recurrence rate were analyzed as indicators. The data were extracted and a meta-analysis was performed by the RevMan 5.3 software.

Results

The 11 randomized controlled studies involving 29 000 patients from 1996 to 2016 were included for the meta-analysis. The extended adjuvant endocrine therapy for more than 5 years did not significantly improve the overall survival in the early breast cancer patients with ER positive (OR=1.02, 95%CI: 0.90-1.15, P=0.790), but it improved the disease-free survival (OR=0.87, 95%CI: 0.75-0.99, P=0.040) and breast cancer-specific survival (OR=0.87, 95%CI: 0.79-0.96, P=0.004) and reduced the recurrence rate (OR=0.76, 95%CI: 0.64-0.90, P=0.001). The early breast cancer patients with estrogen receptor positive could benefit from extended adjuvant endocrine therapy for more than 5 years.

Conclusion

For ER-positive patients with early-stage breast cancer, it is recommended to extend the adjuvant endocrine therapy for over 5 years.

Key words: Breast neoplasms, Estrogen receptor, Disease-free survival, Recurrence

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