Garassino I, Gullo G, Orefice S, Tondulli L, Masci G, Salvini P, Eboli M, Di Tommaso L, Giordano L, Alloisio M, Roncalli M, Santoro A
Department of Oncology and Hematology, Istituto Clinico Humanitas IRCCS, 20089 Rozzano (Milano), Italy.
Breast. 2009 Aug;18(4):263-6. doi: 10.1016/j.breast.2009.07.003. Epub 2009 Aug 13.
T1N0M0 (stage I) breast cancer (BC) has been increasing in recent decades but the optimal adjuvant approach remains controversial. To assess the outcome of BC patients stratified and treated with multimodal therapies according to St. Gallen consensus meeting recommendations, we retrospectively evaluated an unselected cohort of T1N0M0 BC patients, with respect to the St. Gallen criteria. At a median follow-up of 5 years, the recurrence rate, recurrence-free survival and overall survival were 7%, 94% and 96% respectively, and 60% of relapses were locoregional. No statistically significant difference was observed between T1a,b/T1c groups, or among risk categories (high/intermediate/low). The very low rate of distant recurrences even in patients with unfavorable prognostic factors seems to support the use of adjuvant systemic therapies but better prognostic and predictive factors are strongly needed for this subset of patients.
近几十年来,T1N0M0(I期)乳腺癌(BC)的发病率一直在上升,但最佳辅助治疗方法仍存在争议。为了评估根据圣加仑共识会议建议进行分层并接受多模式治疗的BC患者的预后,我们根据圣加仑标准对一组未经选择的T1N0M0 BC患者进行了回顾性评估。在中位随访5年时,复发率、无复发生存率和总生存率分别为7%、94%和96%,60%的复发为局部区域复发。在T1a、b/T1c组之间或风险类别(高/中/低)之间未观察到统计学上的显著差异。即使在具有不良预后因素的患者中,远处复发率也非常低,这似乎支持使用辅助性全身治疗,但对于这部分患者,迫切需要更好的预后和预测因素。