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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.7
- 수록면
- 739 - 747 (9page)
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초록· 키워드
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Purpose In a recent meta-analysis, post-mastectomy radiotherapy (PMRT) reduced any first recurrence (AFR) and improved survival in N1 and N2 patients. We investigated risk factors for AFR in N1 after optimal systemic therapy without PMRT, to define a subgroup of patients who may benefit from PMRT.
Materials and Methods One thousand three hundred eighty-two pT1-2N1M0 breast cancer patients treated with mastectomy without PMRT between 2005 and 2010 were retrospectively analyzed. Only 0.6% had no systemic therapy.
Results After a median follow-up of 5.9 years, there were 173 AFR (53 loco-regional recurrence [LRR] without distant metastases [DM], 38 LRR with DM, and 82 DM without LRR). The 5-year LRR and AFR rates were 6.1% and 12.0%, respectively. Multivariate analysis revealed that close resection margin (p=0.001) was the only independent risk factor for LRR. Multivariate analysis for AFR revealed that age < 35 years (p=0.025), T2 stage (p=0.004), high tumor grade (p=0.032), close resection margin (p=0.035), and triple-negative biological subtype (p=0.031) were independent risk factors. Two or three positive lymph nodes (p=0.078) were considered a marginally significant factor. When stratified by these six factors, the 5-year LRR rates were 3.6% with 0-1 (n=606), 7.5% with 2-3 (n=655), and 12.7% with 4-6 (n=93) risk factors. The 5-year AFR rates were 7.1% with 0-1, 15.0% with 2-3, and 24.5% with 4-6 risk factors.
Conclusion Patients with pT1-2N1M0 breast cancer who underwent mastectomy and optimal systemic therapy showed excellent loco-regional control and disease control. The patients with four or more risk factors may benefit from PMRT, and those with two or three risk factors merit consideration of PMRT.
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참고문헌 (21)
참고문헌 신청
Coates AS / 2015 / Tailoring therapies : improving the management of early breast cancer : St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015 / Ann Oncol 26:1533~1546
Gradishar WJ / 2016 / Invasive Breast Cancer Version 1.2016, NCCN Clinical Practice Guidelines in Oncology / J Natl Compr Canc Netw 14:324~354
강진규 / 2016 / The clinical utilization of radiation therapy in Korea between 2009 and 2013 / Radiation oncology journal 34(2):88~95
Recht A / 2001 / Postmastectomy radiotherapy : clinical practice guidelines of the American Society of Clinical Oncology / J Clin Oncol 19:1539~1569
EBCTCG(Early Breast Cancer Trialists' Collaborative Group) / 2014 / Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality : metaanalysis of individual patient data for 8135 women in 22 randomised trials / Lancet 383:2127~2135
Gradishar WJ / 2016 / Invasive Breast Cancer Version 1.2016, NCCN Clinical Practice Guidelines in Oncology / J Natl Compr Canc Netw 14:324~354
강진규 / 2016 / The clinical utilization of radiation therapy in Korea between 2009 and 2013 / Radiation oncology journal 34(2):88~95
Recht A / 2001 / Postmastectomy radiotherapy : clinical practice guidelines of the American Society of Clinical Oncology / J Clin Oncol 19:1539~1569
EBCTCG(Early Breast Cancer Trialists' Collaborative Group) / 2014 / Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality : metaanalysis of individual patient data for 8135 women in 22 randomised trials / Lancet 383:2127~2135
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