Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, Korea.
Cancer Res Treat. 2018 Oct;50(4):1316-1323. doi: 10.4143/crt.2017.575. Epub 2018 Jan 8.
The aim of this study is to compare the treatment outcomes of breast conserving surgery (BCS) plus radiotherapy (RT) versus mastectomy for patients with pT1-2N1 triple-negative breast cancer (TNBC).
Using two multicenter retrospective studies on breast cancer, a pooled analysis was performed among 320 patients with pT1-2N1 TNBC. All patients who underwent BCS (n=212) receivedwhole breast RTwith orwithoutregional nodal RT,while nonewho underwent mastectomy (n=108)received it. All patients received taxane-based adjuvant chemotherapy. The median follow-up periods were 65 months in the BCS+RT group, and 74 months in the mastectomy group.
The median age of all patients was 48 years (range, 24 to 70 years). Mastectomy group had more patients with multiple tumors (p < 0.001), no lymphovascular invasion (p=0.001), higher number of involved lymph node (p=0.028), and higher nodal ratio ≥ 0.2 (p=0.037). Other characteristics were not significantly different between the two groups. The 5-year locoregionalrecurrence-free, disease-free, and overall survivalrates of BCS+RT group versus mastectomy group were 94.6% versus 87.7%, 89.5% versus 80.4%, and 95.0% versus 87.8%, respectively, and the differences were statistically significant after adjusting for covariates (p=0.010, p=0.006, and p=0.005, respectively).
In pT1-2N1 TNBC, breast conservation therapy achieved better locoregional recurrencefree, disease-free, and overall survival rates compared with mastectomy.
本研究旨在比较保乳手术(BCS)加放疗(RT)与乳房切除术治疗 pT1-2N1 三阴性乳腺癌(TNBC)患者的治疗效果。
利用两项关于乳腺癌的多中心回顾性研究,对 320 例 pT1-2N1 TNBC 患者进行了汇总分析。所有接受 BCS(n=212)的患者均接受全乳 RT 治疗,其中部分患者还接受区域淋巴结 RT 治疗,而接受乳房切除术(n=108)的患者均未接受 RT 治疗。所有患者均接受紫杉烷类辅助化疗。BCS+RT 组的中位随访时间为 65 个月,乳房切除术组为 74 个月。
所有患者的中位年龄为 48 岁(范围:24 至 70 岁)。与 BCS+RT 组相比,乳房切除术组患者的肿瘤数量更多(p<0.001),无脉管侵犯(p=0.001),淋巴结受累数量更多(p=0.028),淋巴结比值≥0.2(p=0.037)。其他特征两组间无显著差异。BCS+RT 组与乳房切除术组的 5 年局部区域无复发生存率、无病生存率和总生存率分别为 94.6%比 87.7%、89.5%比 80.4%和 95.0%比 87.8%,校正协变量后差异具有统计学意义(p=0.010、p=0.006 和 p=0.005)。
在 pT1-2N1 TNBC 中,与乳房切除术相比,保乳治疗可获得更好的局部区域无复发生存率、无病生存率和总生存率。