Breast Surgical Unit, Department of Gynaecology, Hospital Universitario Vall d'Hebron, Passeig Vall d'Hebron 119, 08035 Barcelona, Spain.
Eur J Surg Oncol. 2010 Jun;36(6):528-34. doi: 10.1016/j.ejso.2010.04.004. Epub 2010 May 5.
One of the benefits of neoadjuvant chemotherapy (NAC) is its ability to convert patients ineligible for breast conservative treatment (BCT) to be candidates for this treatment, although questions have been raised regarding the effectiveness of BCT in terms of loco-regional recurrence (LRR). The objective of this study is to evaluate LRR in this group and the influence of tumor characteristics in recurrence.
Between 1996 and 2007, 137 patients were treated with BCT after NAC at our Service. After completion of NAC a multidisciplinary team evaluated the cases eligible for BCT. All patients treated with BCT had negative margins and received radiation therapy. Risk factors associated with local recurrence were analyzed using Kaplan-Meier survival curves and long-rang test.
Information was obtained in 121 patients. Median age was 54 years old (SD: 12 years). At a median follow-up of 35 months (range, 18-87 months), 6 (4.95%) patients developed an LRR, with an accumulative incidence at 5 years of 7.3% (95% CI: 0.4-14.1%) and at 10 years of 11.5% (95% CI: 2.8-20.1%). Overall survival at 5 and 10 years was 94.8% (95% CI: 90.9-98.6%) and 82.3% (95% CI: 67.3-97.2%) respectively. Tumor size (T3) (p < 0.001) and pathological stage (Stage III) (p = 0.001) after surgery were strongly associated with LRR.
The results of this study confirm that BCT is an effective treatment in patients with NAC. Tumor size and pathological stage after systemic treatment influence loco-regional recurrence in patients with BCT.
新辅助化疗（NAC）的益处之一是能够使原本不符合保乳治疗（BCT）条件的患者成为该治疗的候选者，尽管人们对 BCT 在局部区域复发（LRR）方面的有效性提出了质疑。本研究的目的是评估该组患者的 LRR 情况以及肿瘤特征对复发的影响。
1996 年至 2007 年间，我们科室有 137 例患者在接受 NAC 后接受了 BCT 治疗。NAC 完成后，一个多学科团队评估了适合 BCT 的病例。所有接受 BCT 治疗的患者均为阴性切缘，并接受了放射治疗。使用 Kaplan-Meier 生存曲线和 long-rang 检验分析与局部复发相关的危险因素。
共获得 121 例患者的信息。中位年龄为 54 岁（标准差：12 岁）。中位随访时间为 35 个月（范围：18-87 个月），6 例（4.95%）患者发生 LRR，5 年累积发生率为 7.3%（95%CI：0.4-14.1%），10 年累积发生率为 11.5%（95%CI：2.8-20.1%）。5 年和 10 年的总生存率分别为 94.8%（95%CI：90.9-98.6%）和 82.3%（95%CI：67.3-97.2%）。术后肿瘤大小（T3）（p<0.001）和病理分期（III 期）（p=0.001）与 LRR 密切相关。
本研究结果证实，BCT 是 NAC 患者的一种有效治疗方法。全身治疗后肿瘤大小和病理分期影响 BCT 患者的局部区域复发。
