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Local relapse after breast-conserving surgery and radiotherapy: effects on survival parameters.
- Source :
-
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] [Strahlenther Onkol] 2009 Jul; Vol. 185 (7), pp. 431-7. Date of Electronic Publication: 2009 Aug 28. - Publication Year :
- 2009
-
Abstract
- Purpose: This retrospective analysis of 1,610 women treated for breast cancer and 88 patients with local relapse aims to show the poor survival parameters after local failure and to evaluate risk factors and compare them with other studies and analyses published.<br />Patients and Methods: Between 1984 and 1997, 1,610 patients presenting with a total of 1,635 pT1-2 invasive and noninvasive carcinomas of the breast were treated at the authors' institution. The mean age was 57.1 years (range 25-85 years). Treatment protocols involved breast-conserving surgery with or without systemic therapy and whole-breast radiotherapy in all women, followed by a boost dose to the tumor bed according to risk factors for local recurrence. All axillary node-positive patients underwent systemic therapy (six cycles of classic CMF or tamoxifen 20 mg/day for 2-5 years). The time of diagnosis of local relapse was defined as time 0 for the survival curves after local failure. The association of clinicopathologic factors was studied using uni- and multivariate analyses. Survival and local control were calculated by the Kaplan-Meier actuarial method and significance by the log-rank test.<br />Results: After a mean follow-up of 104 months, 88 local failures were recorded (5.4%). Calculated from the time of diagnosis of local relapse, 5-year overall survival (OS) was 62.8%, metastasis-free survival 60.6%, and disease-specific survival 64.2%. In patients with failure during the first 5 years after treatment, the survival parameters were worse (OS 50.6%) compared to those who relapsed after 5 years (OS 78.8%; p < 0.028). Significances were also found for initial T- and N-stage and type of failure (solid tumor vs. diffuse spread).<br />Conclusion: This analysis again shows that the survival parameters are worsening after local relapse, especially in case of early occurrence. In breast cancer treatment, therefore, the goal remains to avoid local failure.
- Subjects :
- Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Breast Neoplasms mortality
Breast Neoplasms pathology
Chemotherapy, Adjuvant
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Lymphatic Metastasis radiotherapy
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Prognosis
Radiotherapy, Adjuvant
Retrospective Studies
Risk Factors
Breast Neoplasms radiotherapy
Breast Neoplasms surgery
Mastectomy, Segmental
Neoplasm Recurrence, Local mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1439-099X
- Volume :
- 185
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
- Publication Type :
- Academic Journal
- Accession number :
- 19714304
- Full Text :
- https://doi.org/10.1007/s00066-009-1983-y