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局部寡转移复发性乳腺癌患者的生存及预后因素

Survival and Prognostic Factors for Breast Cancer Patients with Regional Oligo-Recurrence.

作者信息

Baek Jong Yun, Choi Doo Ho, Park Won, Kim Haeyoung, Cho Won Kyung, Yoo Gyu Sang

机构信息

Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Breast Cancer. 2020 Dec;23(6):622-634. doi: 10.4048/jbc.2020.23.e66.

Abstract

PURPOSE

This study aimed to evaluate survival outcomes and identify prognostic factors for regional oligo-recurrence in breast cancer patients who received salvage local treatment.

METHODS

In the breast cancer registry of our institution, 18,790 patients received curative surgery for stage I-III breast cancer between January 1995 and June 2016. Of those patients, only 87 (0.5%)underwent salvage local treatment for isolated nodal recurrence on the axillary lymph nodes (ALNs) (n = 58), supraclavicular lymph nodes (SCNs) (n = 17), or internal mammary lymph nodes (IMNs) (n = 12).

RESULTS

The median follow-up duration after regional oligo-recurrence was 49 months (range: 6-194 months). For patients with recurrence of ALN, SCN, or IMN, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 40.0%, 32.1%, and 25.0%, respectively ( = 0.3) and 62.7%, 70.0%, and 58.3%, respectively( = 0.97). In the multivariable analysis for PFS, age at recurrence ≥ 65 years, disease-free interval < 24 months, non-luminal A subtype, and in-field failure (marginally significant) were found to be risk factors (RFs). However, the location of the tumor was not a significant factor for PFS ( = 0.71). When we stratified patients by the number of RFs, the 5-year PFS rates were 67.5% for patients with ≤ 1 RF and 7.3% for those with > 1 RF ( < 0.01). For patients with ≤ 1 RF, the 5-year PFS rates were 73.5% in the ALN group and 51.1% in the SCN/IMN group ( = 0.09). For patients with > 1 RF, the 5-year PFS rates were 7.3% in the ALN group and 7.1% in the SCN/IMN group ( = 1.00).

CONCLUSION

In breast cancer patients with regional oligo-recurrence, clinical outcomes after salvage treatment were favorable in patients with ≤ 1 RF, while patients with > 1 RF had poor prognoses irrespective of the location of recurrence.

摘要

目的

本研究旨在评估接受挽救性局部治疗的乳腺癌患者的生存结局,并确定区域寡转移复发的预后因素。

方法

在我们机构的乳腺癌登记系统中,1995年1月至2016年6月期间,18790例I-III期乳腺癌患者接受了根治性手术。在这些患者中,只有87例(0.5%)因腋窝淋巴结(ALN)(n = 58)、锁骨上淋巴结(SCN)(n = 17)或内乳淋巴结(IMN)(n = 12)孤立性淋巴结复发而接受了挽救性局部治疗。

结果

区域寡转移复发后的中位随访时间为49个月(范围:6-194个月)。对于ALN、SCN或IMN复发的患者,5年无进展生存期(PFS)和总生存期(OS)率分别为40.0%、32.1%和25.0%(P = 0.3)以及62.7%、70.0%和58.3%(P = 0.97)。在PFS的多变量分析中,复发时年龄≥65岁、无病间期<24个月、非腔面A型亚型和野内失败(边缘显著)被发现是危险因素(RFs)。然而,肿瘤位置对PFS不是一个显著因素(P = 0.71)。当我们根据RFs数量对患者进行分层时,≤1个RF的患者5年PFS率为67.5%,>1个RF的患者为7.3%(P<0.01)。对于≤1个RF的患者,ALN组5年PFS率为73.5%,SCN/IMN组为51.1%(P = 0.09)。对于>1个RF的患者,ALN组5年PFS率为7.3%,SCN/IMN组为7.1%(P = 1.00)。

结论

在区域寡转移复发的乳腺癌患者中,≤1个RF的患者挽救性治疗后的临床结局良好,而>1个RF的患者无论复发位置如何,预后都较差。

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