Oncologic Safety of Breast-Conserving Surgery Compared to Mastectomy in Patients Receiving Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer
Oncologic Safety of Breast-Conserving Surgery Compared to Mastectomy in Patients Receiving Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer
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DOI：
10.1002/jso.23439
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发表时间：
2013-12-01
影响因子：
2.5
通讯作者：
Park, Byeong-Woo
中科院分区：
文献类型：
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作者：
Cho, Jung Hoon;Park, Ji Min;Park, Byeong-Woo
背景对于通过新辅助化疗（NCT）缩小的大肿瘤患者进行保乳手术（BCS）仍然存在争议。我们调查了接受 NCT 治疗局部晚期乳腺癌 (LABC) 的 BCS 患者的肿瘤学结果。方法我们回顾了 1,994 名接受/未接受 NCT 手术的患者。根据治疗方法将患者分为三组：初始BCS、NCT后BCS（NCT-BCS）和NCT后乳房切除术（NCT-MX）。分析其特征和结果。结果NCT-BCS组比NCT-MX组患有早期癌症、更多的激素受体阴性和三阴性乳腺癌(TNBC)。然而，两组之间的结果没有统计学差异。与未接受 NCT 的 BCS 患者相比，接受 NCT 的 BCS 患者更年轻，并且患有更多晚期、激素受体阴性、HER2 阳性和 TNBC 乳腺癌。 NCT-BCS 组中病理完全缓解 (pCR) 的患者比非 pCR 患者和初始 BCS 组有更好的生存结果。通过对接受 NCT 的患者进行多变量分析，最终分期和 TNBC 与较差的总生存率相关（III 期：P=0.008；TNBC：P=0.01），但手术类型则不然（P=0.20）。结论 NCT 后的 BCS 是对 NCT 反应良好的 LABC 的安全选择。通过 NCT 缩小肿瘤可以在不影响结果的情况下提供更多应用 BCS 的机会。 J.外科医生。安科尔。 2013年； 108：531-536。 (c) 2013 年 Wiley 期刊公司。
BackgroundBreast-conserving surgery (BCS) in patients with large tumors shrunk by neoadjuvant chemotherapy (NCT) remains controversial. We investigated oncologic outcomes of BCS in patients receiving NCT to treat locally advanced breast cancer (LABC).MethodsWe reviewed 1,994 patients who underwent surgery with/without NCT. Patients were categorized into three groups according to treatment methods: initial BCS, BCS after NCT (NCT-BCS), and mastectomy after NCT (NCT-MX). Their characteristics and outcomes were analyzed.ResultsThe NCT-BCS group had earlier stage cancer, more hormone receptor-negative and triple-negative breast cancers (TNBC) than the NCT-MX group. However, outcomes did not differ statistically between the two groups. BCS patients receiving NCT were younger, and had more advanced, hormone receptor-negative, HER2-positive, and TNBC breast cancers than BCS patients without NCT. Patients with pathological complete remission (pCR) in the NCT-BCS group had better survival outcomes than non-pCR patients and the initial BCS group. By multivariate analysis in patients receiving NCT, final stage and TNBC were associated with poor overall survival (stage III: P=0.008; TNBC: P=0.01), however surgery type was not (P=0.20).ConclusionsBCS after NCT is a safe option for LABC that responded well to NCT. Shrinking tumors with NCT allows more opportunities to apply BCS without compromising outcomes. J. Surg. Oncol. 2013; 108:531-536. (c) 2013 Wiley Periodicals, Inc.