浸润性小叶癌新辅助化疗后的切缘评估。
Margin assessment after neoadjuvant chemotherapy in invasive lobular cancer.
作者信息
Wagner Jamie, Boughey Judy C, Garrett Betsy, Babiera Gildy, Kuerer Henry, Meric-Bernstam Funda, Singletary Eva, Hunt Kelly K, Middleton Lavinia P, Bedrosian Isabelle
机构信息
Department of Surgical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
出版信息
Am J Surg. 2009 Sep;198(3):387-91. doi: 10.1016/j.amjsurg.2009.01.006. Epub 2009 Apr 10.
BACKGROUND
Optimal surgical management of patients with invasive lobular carcinoma (ILC) who undergo neoadjuvant chemotherapy (NAC) is unknown. We evaluated optimal margin distance and local recurrence (LR) rates for these patients.
METHODS
Ninety-three (30%) of 311 patients with ILC received NAC. We examined margin status, residual disease after re-excision, and clinical outcomes.
RESULTS
Margin positivity rates after the final operative procedure were similar between the NAC and surgery-first group (P > .05). The proportion of patients, stratified by margin status, who were taken back for re-excision was not different between the 2 groups, and, similarly, there were no differences in frequency of residual disease (all P > .05). At a median follow-up of 3.1 years, 1 patient in the NAC group and 2 in the surgery-first group developed LR (P = 1.0).
CONCLUSIONS
Patients with ILC who have undergone NAC and have margins >1 mm have a low probability of residual disease and LR.
背景
接受新辅助化疗（NAC）的浸润性小叶癌（ILC）患者的最佳手术管理尚不清楚。我们评估了这些患者的最佳切缘距离和局部复发（LR）率。
方法
311例ILC患者中有93例（30%）接受了NAC。我们检查了切缘状态、再次切除后的残留疾病以及临床结局。
结果
NAC组和先手术组在最终手术操作后的切缘阳性率相似（P>.05）。按切缘状态分层后，两组中因切缘问题返回进行再次切除的患者比例没有差异，同样，残留疾病的发生率也没有差异（所有P>.05）。中位随访3.1年时，NAC组有1例患者发生LR，先手术组有2例（P = 1.0）。
结论
接受NAC且切缘>1 mm的ILC患者残留疾病和LR的概率较低。
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