서울특별시보라매병원 / 김병혁, 김수지*
Abstract
Purpose: We aimed to investigate the clinicopathologic factors associated with distant metastasis (DM) and post-recurrence overall survival (OS) after salvage treatments for isolated locoregional recurrence (ILRR) of breast cancer and identify long-term surviving patients for providing a more personalized therapy.
Methods: We analyzed 125 patients who underwent salvage local treatments for ILRR after initial curative breast surgery.
Results: Fifty-two (41.6%) patients experienced secondary recurrence or disease progression, of which 20 (38.5%) experienced a secondary locoregional recurrence and 40 (76.9%) experienced DM as the first site of failure. In multivariate analysis of distant metastasis free survival (DMFS) and post-recurrence OS, the initial pN2-3 stage, a disease-free interval of < 36 months, and non-curative resection for recurrent disease were independently poor prognosticators. The score for patients stratified according to the number of risk factors increased from 0 to 3; the corresponding 5-year DMFS rates were 91.4%, 53.0%, 35.9%, and 0% and the 5-year OS rates were 97.3%, 70.4%, 32.7%, and 25.0%, respectively (p < 0.001). Systemic chemotherapy reduced DM in patients with a score of 2-3, but it did not in those with a score of 0-1.
Conclusion: Our collective stratification can help with prognosis prediction for ILRR of breast cancer. Depending on the DM risk of patients, the potential combination of systemic therapy should be discussed further.
Affiliations
Byoung Hyuck Kim 1 , Kyung Hwan Shin 2 , Eui Kyu Chie 2 , Jin Ho Kim 2 , Kyubo Kim 3 , Ki-Tae Hwang 4 , Jongjin Kim 4 , In Sil Choi 5 , Jin Hyun Park 5 , Suzy Kim 1
1 Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
2 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
3 Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea.
4 Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
5 Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.