Yildirim E
Department of Surgery, Ankara Oncology Training and Research Hospital, Turkey.
Eur J Surg Oncol. 2009 Mar;35(3):258-63. doi: 10.1016/j.ejso.2008.06.010. Epub 2008 Jul 21.
To assess the risk of locoregional recurrence (LRR) after mastectomy and to identify predictive and treatment factors that affect the risk of LRR.
The primary endpoint was local recurrence. Univariate and multivariate Cox regression analyses were carried out in the data from 1217 patients.
The median follow-up was 74 months, and 63 (5.2%) patients experienced a LRR in their follow-up period. In the multivariate analysis, age group (< or =35 years vs. >35 years, p<0.0001; Hazard Ratio [HR], 5.0; 95% Confidence Interval [95% CI], 3.0-8.3), tumour size (>2 cm vs. < or =2 cm, p=0.03; HR, 2.2; 95% CI, 1.2-4.7) and LVI (yes vs. no, p<0.0001; HR, 3.2; 95% CI,1.9-5.2) were the independent prognostic factors for LRR. This analysis, in the final model, indicated that adjuvant radiotherapy and adjuvant tamoxifen were associated with a reduced risk of LRR by 90% and 75%, respectively, across the follow-up period, whereas age group remained as an important risk factor (p=0.002; HR, 3.0; 95% CI, 1.5-6.2).
Although adjuvant therapies reduce the risk of LRR, young age is an independent risk factor for LRR.
评估乳房切除术后局部区域复发(LRR)的风险,并确定影响LRR风险的预测因素和治疗因素。
主要终点为局部复发。对1217例患者的数据进行单因素和多因素Cox回归分析。
中位随访时间为74个月,63例(5.2%)患者在随访期间出现LRR。在多因素分析中,年龄组(≤35岁与>35岁,p<0.0001;风险比[HR],5.0;95%置信区间[95%CI],3.0 - 8.3)、肿瘤大小(>2 cm与≤2 cm,p = 0.03;HR,2.2;95%CI,1.2 - 4.7)和淋巴管浸润(是与否,p<0.0001;HR,3.2;95%CI,1.9 - 5.2)是LRR的独立预后因素。该分析在最终模型中表明,在整个随访期间,辅助放疗和辅助他莫昔芬分别使LRR风险降低90%和75%;而年龄组仍然是一个重要的风险因素(p = 0.002;HR,3.0;95%CI,1.5 - 6.2)。
虽然辅助治疗可降低LRR风险,但年轻是LRR的独立风险因素。