Baek Jong Yun, Choi Doo Ho, Park Won, Kim Haeyoung, Cho Won Kyung, Yoo Gyu Sang
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Breast Cancer. 2020 Dec;23(6):622-634. doi: 10.4048/jbc.2020.23.e66.
This study aimed to evaluate survival outcomes and identify prognostic factors for regional oligo-recurrence in breast cancer patients who received salvage local treatment.
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).
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).
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.
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。
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。
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)。
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。