Voogd A C, van Oost F J, Rutgers E J T, Elkhuizen P H M, van Geel A N, Scheijmans L J E E, van der Sangen M J C, Botke G, Hoekstra C J, Jobsen J J, van de Velde C J H, von Meyenfeldt M F, Tabak J M, Peterse J L, van de Vijver M J, Coebergh J W W, van Tienhoven G
Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Eur J Cancer. 2005 Nov;41(17):2637-44. doi: 10.1016/j.ejca.2005.04.040. Epub 2005 Aug 22.
We have studied the long-term prognosis of 266 patients considered to have isolated local recurrence in the breast following conservative surgery and radiotherapy for early breast cancer. The median follow-up of the patients still alive after diagnosis of local relapse was 11.2 years. At 10 years from the date of salvage treatment, the overall survival rate for the 226 patients with invasive local recurrence was 39% (95% CI, 32-46), the distant recurrence-free survival rate was 36% (95% CI, 29-42), and the local control rate (i.e., survival without subsequent local recurrence or local progression) was 68% (95% CI, 62-75). Among patients with a local recurrence at or near the original tumour site a better distant disease-free survival was observed for patients with recurrences measuring 1cm or less, compared to those with larger recurrences. This suggests, though does not prove, that early detection of local recurrence can improve the treatment outcome but might as well point towards a different biologic behaviour, facilitating early detection.
我们研究了266例早期乳腺癌保乳手术及放疗后被认为出现孤立性局部复发的患者的长期预后。诊断局部复发后仍存活患者的中位随访时间为11.2年。从挽救性治疗日期起10年时，226例浸润性局部复发患者的总生存率为39%（95%可信区间，32 - 46），无远处复发生存率为36%（95%可信区间，29 - 42），局部控制率（即无后续局部复发或局部进展的生存率）为68%（95%可信区间，62 - 75）。在原肿瘤部位或其附近出现局部复发的患者中，复发灶直径1cm或更小的患者与复发灶较大的患者相比，远处无病生存率更高。这表明，虽然不能证明，但局部复发的早期检测可改善治疗结果，也可能提示不同的生物学行为，便于早期检测。
