Carlson Grant W, Styblo Toncred M, Lyles Robert H, Jones Glyn, Murray Douglas R, Staley Charles A, Wood William C
Winship Cancer Institute, Emory University School of Medicine, Emory University, 1365B, Clifton Road, Atlanta, GA 30322, USA.
Surg Oncol. 2003 Dec;12(4):265-9. doi: 10.1016/j.suronc.2003.09.002.
Long-term follow-up of the use of skin sparing mastectomy (SSM) in the treatment of breast cancer is presented to determine the impact of local recurrence (LR) on survival.
565 cases of breast cancer were treated by SSM and IBR from 1/1/1989-12/31/1998. The AJCC pathological staging was Stage 0 175 (31%), Stage I 135 (23.9%), Stage II 173 (30.6%), Stage III 54 (9.6%), Stage IV 8 (1.4%), recurrent 20 (3.5%). Forty-one patients received postoperative adjuvant radiation therapy.
Thirty-one patients developed a LR during the follow-up including five who received adjuvant radiation. The distribution of LR stratified by cancer stage was Stage 0 1 (3.2%), Stage I 5 (16.1%), Stage II 17 (54.8%), Stage III 6 (19.4%), and recurrent 2 (6.5%). The overall LR was 5.5%. Isolated LRs were treated with surgical resection and radiation therapy if not previously administered. Twenty-four patients (77.4%) developed a systemic relapse and 7 (22.6%) patients remained free of recurrent disease at a mean follow-up of 78.1 months. The cancer stage of those remaining disease free was Stage 0 1, Stage I 4, and Stage II 2.
LR of breast cancer after SSM is not always associated with systemic relapse.
本文介绍了对保乳根治术（SSM）治疗乳腺癌的长期随访情况，以确定局部复发（LR）对生存的影响。
1989年1月1日至1998年12月31日期间，565例乳腺癌患者接受了保乳根治术和即刻乳房重建术（IBR）。美国癌症联合委员会（AJCC）病理分期为0期175例（31%），I期135例（23.9%），II期173例（30.6%），III期54例（9.6%），IV期8例（1.4%），复发20例（3.5%）。41例患者接受了术后辅助放疗。
31例患者在随访期间出现局部复发，其中5例接受了辅助放疗。按癌症分期分层的局部复发分布为：0期1例（3.2%），I期5例（16.1%），II期17例（54.8%），III期6例（19.4%），复发2例（6.5%）。总体局部复发率为5.5%。孤立性局部复发患者接受手术切除治疗，若之前未进行放疗则加行放疗。平均随访78.1个月时，24例患者（77.4%）出现全身复发，7例患者（22.6%）无疾病复发。无疾病复发患者的癌症分期为：0期1例，I期4例，II期2例。
保乳根治术后乳腺癌局部复发并不总是与全身复发相关。
Zotero 插件