Early Local Recurrence Presents Adverse Effect on Outcomes of Primary Breast Sarcoma: A Retrospective Study From Single Institute in China.
Early Local Recurrence Presents Adverse Effect on Outcomes of Primary Breast Sarcoma: A Retrospective Study From Single Institute in China.
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DOI：
10.1097/md.0000000000002422
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发表时间：
2016-01
期刊：
影响因子：
1.6
通讯作者：
Guo XM
中科院分区：
文献类型：
--
作者：
Hu QC;Mei X;Feng Y;Ma JL;Yang ZZ;Shao ZM;Yu XL;Guo XM
原发性乳腺肉瘤是一种分布广泛的异质性乳腺肉瘤，其最佳治疗方法仍在探讨中。我们的研究旨在探讨这种罕见恶性肿瘤的临床特征并确定潜在的预后因素。作者回顾性分析了复旦大学附属肿瘤医院2000年10月至2014年2月收治的38例PBS患者。采用Kaplan-Meier精算法计算局部控制率和总生存期。单因素分析和考克斯比例风险模型用于识别潜在的预后因素。中位随访40.19个月，14例（14/38）局部复发。扩大手术如乳腺切除术并不上级局部切除术（P = 0.167）。 3年无复发生存率和OS率分别为61.9%和89%。单因素分析显示，肿瘤较大和局部复发是不利的预后因素。考克斯模型将无复发生存期间隔较窄列为不利因素（P = 0.048）。 外科手术仍然是PBS的重要治疗方法。然而，如果局部切除可以获得清晰的边缘，则不需要常规切除。早期复发表明OS较差。
Primary breast sarcomas (PBSs) are spectrum heterogeneous sarcomas in breast and the optimal treatment for them is still under discussion. Our study was to investigate clinical characteristics and identify potential prognostic factors for this rare malignancy. The authors retrospectively reviewed 38 patients with PBSs between October 2000 and February 2014 in FuDan University Shanghai Cancer Center. Local control rate and overall survival (OS) were determined by Kaplan–Meier actuarial method. Univariate analysis and Cox proportional hazards model were applied to identify potential prognostic factors. With median follow-up of 40.19 months, 14 patients (14/38) were found with local recurrence. Extensive operation like mastectomy was not superior to local resection (P = 0.167). Three-year recurrence-free survival and OS rate were 61.9% and 89%, respectively. Larger tumor size and local recurrence were indicated as unfavorable prognostic factors in univariate analysis. Cox model identified narrow interval of recurrence free survival as an unfavorable factor (P = 0.048). Surgery remains crucial treatment for PBSs. Mastectomy, however, is not routinely necessary if clear margin could be achieved by local excision. Early recurrence indicates a poor OS.