Inflammatory Breast Cancer: Patterns of Failure and the Case for Aggressive Locoregional Management
Inflammatory Breast Cancer: Patterns of Failure and the Case for Aggressive Locoregional Management
复制标题
DOI：
10.1245/s10434-015-4469-4
复制
发表时间：
2015-08-01
影响因子：
3.7
通讯作者：
Bellon, Jennifer R.
中科院分区：
文献类型：
--
作者：
Warren, Laura E. G.;Guo, Hao;Bellon, Jennifer R.
炎症性乳腺癌（IBC）是一种罕见的侵袭性亚型。本研究分析了我院IBC患者治疗失败的模式。我们回顾性分析了1997年至2011年间227名IBC女性患者的记录。生存分析用于计算总生存期（OS）和无病生存期。竞争风险分析用于计算局部区域复发（LRR）。共有173名患者在就诊时仅患有局部区域疾病（非met）。存活患者的中位随访时间为3.3年。总的来说，132例（76.3%）患者接受了化疗、手术和放疗的三位一体治疗。3年OS为73.1%[95%置信区间（CI） 64.9-82.4]。1年、2年和3年的累积LRR分别为10.1%、16.9%和21.3%。没有变量与LRR显著相关。54例患者出现转移性疾病（MET）。存活患者的中位随访时间为2.6年。3年OS为44.3% （95% CI 31.4-62.5）。24例（44.4%）患者接受了非姑息性局部治疗（放疗和/或手术）。这些患者局部治疗后的中位OS为2年。排除6例接受局部治疗以缓解症状的患者，接受局部治疗的患者局部进展或复发（LRPR）的粗发生率为17%(4/24)，而未接受局部治疗的患者为57%（13/23）。对于非met患者，尽管进行了三段式治疗，LRR仍然是一个问题。更积极的治疗是必要的。对于MET患者，近60%的患者在单独的全身治疗下有LRPR。在转移性疾病的情况下，应考虑局部治疗，以防止潜在的进展性局部疾病的发病率。
Inflammatory breast cancer (IBC) is a rare and aggressive subtype. This study analyzes the patterns of failure in patients with IBC treated at our institution.We retrospectively analyzed the records of 227 women with IBC presenting between 1997 and 2011. Survival analysis was used to calculate overall survival (OS) and disease-free survival. Competing risk analysis was used to calculate locoregional recurrence (LRR).A total of 173 patients had locoregional-only disease at presentation (non-MET). Median follow-up in the surviving patients was 3.3 years. Overall, 132 (76.3 %) patients received trimodality therapy with chemotherapy, surgery, and radiotherapy. Three-year OS was 73.1 % [95 % confidence interval (CI) 64.9-82.4]. Cumulative LRR was 10.1, 16.9, and 21.3 % at 1, 2, and 3 years, respectively. No variable was significantly associated with LRR. Fifty-four patients had metastatic disease at presentation (MET). Median follow-up in the surviving patients was 2.6 years. Three-year OS was 44.3 % (95 % CI 31.4-62.5). Twenty-four (44.4 %) patients received non-palliative local therapy (radiotherapy and/or surgery). For these patients, median OS after local therapy was 2 years. Excluding six patients who received local therapy for symptom palliation, the crude incidence of locoregional progression or recurrence (LRPR) was 17 % (4/24) for those who received local therapy compared with 57 % (13/23) for those who did not.For non-MET patients, LRR remains a problem despite trimodality therapy. More aggressive treatment is warranted. For MET patients, nearly 60 % have LRPR with systemic therapy alone. Local therapy should be considered in the setting of metastatic disease to prevent potential morbidity of progressive local disease.