Fowble B, Solin L J, Schultz D J, Goodman R L
Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia.
Int J Radiat Oncol Biol Phys. 1989 Oct;17(4):703-10. doi: 10.1016/0360-3016(89)90055-2.
Between 1970 and 1986, 990 patients underwent excisional biopsy and radiation for clinical Stage I or II breast cancer. A limited axillary dissection (levels I and II) was performed in 914 of these patients. The median follow-up was 40 months from the initiation of radiation. Thirty-one patients developed a regional node failure as their first site of recurrence either with (12 patients) or without (19 patients) simultaneous distant metastases. The median interval to recurrence was 27 months (range 4-59). The 5-year actuarial rate for an isolated regional node recurrence (without simultaneous distant metastases) was 3%. The most common site for a regional node failure was the axilla (17 patients) followed by the supraclavicular nodes (13 patients). Salvage therapy was effective for an axillary +/- breast failure with 10/14 patients alive with no evidence of disease. Prognosis was related to the site of recurrence as well as the presence or absence of distant metastases. The 5-year actuarial survival from initial treatment for all patients with a regional node failure was 63% with a 3-year actuarial survival of 57% from diagnosis of recurrence. Regional node failure was related to the number of axillary nodes removed at the time of dissection and patient age.
1970年至1986年间，990例临床I期或II期乳腺癌患者接受了切除活检及放疗。其中914例患者进行了有限腋窝清扫术（I级和II级）。放疗开始后的中位随访时间为40个月。31例患者出现区域淋巴结复发，为首个复发部位，其中12例伴有同时性远处转移，19例不伴有同时性远处转移。复发的中位间隔时间为27个月（范围4 - 59个月）。孤立区域淋巴结复发（无同时性远处转移）的5年精算发生率为3%。区域淋巴结复发最常见的部位是腋窝（17例患者），其次是锁骨上淋巴结（13例患者）。挽救性治疗对腋窝±乳腺复发有效，14例患者中有10例存活且无疾病证据。预后与复发部位以及是否存在远处转移有关。所有区域淋巴结复发患者初始治疗后的5年精算生存率为63%，从复发诊断起的3年精算生存率为57%。区域淋巴结复发与清扫时切除的腋窝淋巴结数量及患者年龄有关。
