Lee Min-Young, Chang Won Jin, Kim Hae Su, Lee Ji Yun, Lim Sung Hee, Lee Jeong Eon, Kim Seok Won, Nam Seok Jin, Ahn Jin Seok, Im Young-Hyuck, Park Yeon Hee
Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
PLoS One. 2016 Sep 20;11(9):e0163254. doi: 10.1371/journal.pone.0163254. eCollection 2016.
The purpose of this study was to investigate the clinicopathologic features and prognostic factors affecting outcome in patients with isolated locoregional recurrence of breast cancer (ILRR).
We retrospectively analyzed the medical records of 104 patients who were diagnosed with ILRR and underwent curative surgery from January 2000 to December 2010 at Samsung Medical Center.
Among 104 patients, 43 (41%) underwent total mastectomy and 61 (59%) underwent breast-conserving surgery for primary breast cancer. The median time from initial operation to ILRR was 35.7 months (4.5-132.3 months). After diagnosis of ILRR, 45 (43%) patients were treated with mastectomy, 41 (39%) with excision of recurred lesion, and 18 (17%) with node dissection. During a median follow-up of 8.9 years, the 5-year overall survival was 77% and 5-year distant metastasis-free survival (DMFS) was 54%. On multivariate analysis, younger age (< 35 years), higher stage, early onset of elapse (≤ 24 months), lymph node recurrences, and subtype of triple negative breast cancer (TNBC) were found to be independently associated with DMFS. Patients in the no chemotherapy group showed a longer DMFS after surgery for ILRR than those treated with chemotherapy (median 101.5 vs. 48.0 months, p = 0.072) but without statistical significance.
Our analysis showed that younger age (< 35 years), higher stage, early onset of relapse (≤ 24 months), lymph node recurrence, and subtype of TNBC are the worst prognostic factors for ILRR.
本研究旨在探讨孤立性局部区域复发性乳腺癌(ILRR)患者的临床病理特征及影响预后的因素。
我们回顾性分析了2000年1月至2010年12月在三星医疗中心诊断为ILRR并接受根治性手术的104例患者的病历。
104例患者中,43例(41%)因原发性乳腺癌接受了全乳切除术,61例(59%)接受了保乳手术。从初次手术到ILRR的中位时间为35.7个月(4.5 - 132.3个月)。诊断为ILRR后,45例(43%)患者接受了乳房切除术,41例(39%)接受了复发病灶切除术,18例(17%)接受了淋巴结清扫术。在中位随访8.9年期间,5年总生存率为77%,5年无远处转移生存率(DMFS)为54%。多因素分析显示,年龄较小(< 35岁)、分期较高、复发时间较早(≤ 24个月)、淋巴结复发以及三阴性乳腺癌(TNBC)亚型与DMFS独立相关。未化疗组患者ILRR手术后的DMFS长于化疗组患者(中位时间101.5个月对48.0个月,p = 0.072),但无统计学意义。
我们的分析表明,年龄较小(< 35岁)、分期较高、复发较早(≤ 24个月)、淋巴结复发以及TNBC亚型是ILRR预后最差的因素。