Kurtz J M, Spitalier J M, Amalric R, Brandone H, Ayme Y, Bressac C, Hans D
Department of Radiation Oncology, University Hospital, Basel, Switzerland.
Int J Radiat Oncol Biol Phys. 1988 Aug;15(2):271-6. doi: 10.1016/s0360-3016(98)90004-9.
The crude mammary recurrence rate was studied in 5-year age intervals for 1,382 Stage I and II breast cancer patients treated by conservative surgery and radiation therapy and followed for a median of 11 years. Patients younger than 40 had a significantly higher local recurrence rate (41/210, 19%) than did older patients (106/1172, 9%). The majority of excess recurrences in the younger patients occurred early, with recurrence rates between 5 and 10 years being equal for the 2 age groups. A comparison of the clinical characteristics of the patient groups yielded no obvious explanation for the higher local recurrence rate in the younger patients, and 15-year cancer-specific survival was identical. Within the younger age group, recurrence rate was independent of clinical tumor size, and was unaffected by adjuvant treatment. Young patients with positive axillary nodes or negative hormone receptors appear to be at particularly high risk for mammary failure. Despite this apparent correlation with biologic aggressiveness, the 41 patients with mammary recurrence experienced long-term survival from time of primary treatment which was not significantly worse than that of patients not having had local recurrence. For 37 patients with operable mammary recurrence, the 10-year survival from time of salvage surgery was 64%.
对1382例接受保乳手术和放射治疗的Ⅰ期和Ⅱ期乳腺癌患者进行了研究，按5岁年龄间隔分析其粗乳腺复发率，中位随访时间为11年。40岁以下患者的局部复发率（41/210，19%）显著高于老年患者（106/1172，9%）。年轻患者中大多数额外复发发生在早期，两个年龄组在5至10年的复发率相当。对两组患者的临床特征进行比较，未发现年轻患者局部复发率较高的明显原因，且15年癌症特异性生存率相同。在年轻年龄组中，复发率与临床肿瘤大小无关，且不受辅助治疗影响。腋窝淋巴结阳性或激素受体阴性的年轻患者似乎乳腺复发风险特别高。尽管与生物学侵袭性存在明显相关性，但41例乳腺复发患者从初次治疗开始的长期生存率与未发生局部复发的患者相比并无显著更差。对于37例可手术的乳腺复发患者，挽救手术后10年生存率为64%。
