乳腺癌的局部区域复发:治疗方法的回顾性比较

Locoregional recurrence of breast cancer: a retrospective comparison of treatment methods.

作者信息

Skowronek J, Piotrowski T

机构信息

I. Department of Radiotherapy, Greatpoland Cancer Center, Poznań, Poland.

出版信息

Neoplasma. 2002;49(6):426-31.

DOI:
Abstract

The study was made to evaluate the clinical and pathological features of breast cancer patients with locally recurrent breast cancer and to assess the impact of the treatment method on their prognosis. Fifty-four patients with local recurrence after breast cancer were treated in Greatpoland Cancer Center between 1983 and 1995. It constituted 6.2% (54/878) of all patients with breast cancer treated in this period. Median length of interval between primary lesion and recurrence was 26.6 months, in 12/54 cases (22.2%) was longer then 5 years. Patients in time of recognizing primary breast cancer had tumor in clinical stage T2 (n=25) and T3 or T4 (n=29), in stage N0 (n=16) and N1 (n=36). Patients with recurrent breast cancer were treated using different methods. In 26 cases recurrent tumor was excited and then, in 15 cases irradiated, in 11 cases irradiated and additionally treated by chemotherapy or by hormonotherapy. In 28 cases patients were disqualified for excision due to local advance of disease. They were all irradiated and then treated by chemotherapy (n=17) or hormonotherapy (n=11). 5-year survival rates were compared with the chosen clinical factors (age, clinical stage, histopathology), length of interval between primary tumor and recurrence and with different methods of treatment including excision or not. 5-year overall survival rate was 33.3%. In locally advanced tumors (stage T3) the effect was worse then in stage T2 tumors. Five-year survival rates after recurrence were 20.8% and 52.0%, respectively (p=0.001). No statistically important correlations between lymph node involvement, age, histology and survival rate were found. Differences between 5-year survival rate were observed according to length of interval between recognizing the primary lesion and recurrence. Patients with interval shorter then 24 months had survival rate 14.3%, between 24 and 60 months - survival rate 64.3% and with interval longer then 60 months - 41.7%. Statistically important differences were noted between first and second group (p=0.01) and first and third group (p=0.03). Patients treated with local excision followed by radiotherapy and/or systemic therapy had greater 5-year survival rate (53.9%) then patients disqualified for incision (14.3%) (p=0.0001).

摘要

本研究旨在评估局部复发性乳腺癌患者的临床和病理特征,并评估治疗方法对其预后的影响。1983年至1995年间,大波兰癌症中心对54例乳腺癌局部复发患者进行了治疗。这占该时期所有乳腺癌患者的6.2%(54/878)。原发灶与复发之间的中位间隔时间为26.6个月,12/54例(22.2%)间隔时间超过5年。确诊原发性乳腺癌时,患者的肿瘤临床分期为T2期(n = 25)和T3或T4期(n = 29),N0期(n = 16)和N1期(n = 36)。复发性乳腺癌患者采用了不同的治疗方法。26例患者对复发性肿瘤进行了切除,其中15例随后接受了放疗,11例接受了放疗并额外接受了化疗或激素治疗。28例患者因疾病局部进展而不适合切除。他们均接受了放疗,然后接受化疗(n = 17)或激素治疗(n = 11)。将5年生存率与所选临床因素(年龄、临床分期、组织病理学)、原发肿瘤与复发之间的间隔时间以及包括是否切除在内的不同治疗方法进行了比较。5年总生存率为33.3%。在局部晚期肿瘤(T3期)中,效果比T2期肿瘤更差。复发后的5年生存率分别为20.8%和52.0%(p = 0.001)。未发现淋巴结受累、年龄、组织学与生存率之间存在统计学上的显著相关性。根据确诊原发性病变与复发之间的间隔时间,观察到5年生存率存在差异。间隔时间短于24个月的患者生存率为14.3%,24至60个月之间的患者生存率为64.3%,间隔时间长于60个月的患者生存率为41.7%。第一组与第二组(p = 0.01)以及第一组与第三组(p = 0.03)之间存在统计学上的显著差异。接受局部切除后再进行放疗和/或全身治疗的患者5年生存率(53.9%)高于不适合手术切除的患者(14.3%)(p = 0.0001)。

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