Can we predict local recurrence in breast conserving surgery after neoadjuvant chemotherapy?
Can we predict local recurrence in breast conserving surgery after neoadjuvant chemotherapy?
复制标题
DOI：
10.1016/j.ejso.2010.04.004
复制
发表时间：
2010-06-01
期刊：
影响因子：
3.8
通讯作者：
Rubio, I. T.
中科院分区：
文献类型：
--
作者：
Cebrecos, I.;Cordoba, O.;Rubio, I. T.
背景资料：新辅助化疗（NAC）的好处之一是它能够将不适合乳腺保守治疗（BCT）的患者转化为这种治疗的候选人，尽管已经提出了关于BCT在局部区域复发（LRR）方面的有效性的问题。本研究的目的是评估LRR在这一组和肿瘤的特点，在revolution.Material和方法的影响：1996年和2007年之间，137例患者进行了治疗后，在我们的服务NAC BCT。NAC完成后，一个多学科小组评估了符合BCT条件的病例。所有接受BCT治疗的患者切缘均为阴性，并接受了放射治疗。采用Kaplan-Meier生存曲线和长程检验分析局部复发的危险因素。中位年龄为54岁（SD：12岁）。在中位随访35个月（范围：18-87个月）时，6例（4.95%）患者发生了LRR，5年时的累积发生率为7.3%（95% CI：0.4-14.1%），10年时为11.5%（95% CI：2.8-20.1%）。5年和10年的总生存率分别为94.8%（95% CI：90.9-98.6%）和82.3%（95% CI：67.3-97.2%）。手术后肿瘤大小（T3）（p < 0.001）和病理分期（HI期）（p = 0.001）与LRR密切相关。结论：本研究结果证实BCT是NAC患者的有效治疗方法。全身治疗后肿瘤大小和病理分期影响BCT患者的局部复发。(C)2010爱思唯尔有限公司保留所有权利。
Background: One of the benefits of neoadjuvant chemotherapy (NAC) is its ability to convert patients ineligible for breast conservative treatment (BCT) to be candidates for this treatment, although questions have been raised regarding the effectiveness of BCT in terms of loco-regional recurrence (LRR). The objective of this study is to evaluate LRR in this group and the influence of tumor characteristics in recurrence.Material and Methods: Between 1996 and 2007, 137 patients were treated with BCT after NAC at our Service. After completion of NAC a multidisciplinary team evaluated the cases eligible for BCT. All patients treated with BCT had negative margins and received radiation therapy. Risk factors associated with local recurrence were analyzed using Kaplan-Meier survival curves and long-rang test.Results: Information was obtained in 121 patients. Median age was 54 years old (SD: 12 years). At a median follow-up of 35 months (range, 18-87 months), 6(4.95%) patients developed an LRR, with an accumulative incidence at 5 years of 7.3% (95% CI: 0.4-14.1%) and at 10 years of 11.5% (95% Cl: 2.8-20.1%). Overall survival at 5 and 10 years was 94.8% (95% Cl: 90.9-98.6%) and 82.3% (95% CI: 67.3-97.2%) respectively. Tumor size (T3) (p < 0.001) and pathological stage (Stage HI) (p = 0.001) after surgery were strongly associated with LRR.Conclusions: The results of this study confirm that BCT is an effective treatment in patients with NAC. Tumor size and pathological stage after systemic treatment influence loco-regional recurrence in patients with BCT. (C) 2010 Elsevier Ltd. All rights reserved.