期刊文献+

乳腺癌保乳治疗后局部复发的临床研究 被引量:12

The clinical research of local recurrence after breast-conserving therapy for breast cancer
原文传递
导出
摘要 目的 比较分析乳腺癌保乳治疗后局部复发病例与同期非复发病例资料,分析影响局部复发的风险因素.方法 密切随访2000年1月至2008年6月收治的1034例保乳治疗患者.患者年龄23~94岁,中位年龄48岁.分析年龄、雌激素受体(ER)/孕激素受体(PR)状态、人类表皮生长因子受体2(HER-2)状态、淋巴结转移状态、肿瘤大小、新辅助化疗、病理类型对局部复发的影响.结果 随访截至2010年6月,中位随访42个月(3~126个月),同侧乳房局部复发35例(3.3%),远位转移47例(4.5%),5年无病生存率87.7%,5年无远处转移生存率94.0%,5年总体生存率99.3%.单因素分析显示,淋巴结状态、年龄及HER-2表达状态是影响局部复发的风险因素;复发高峰时间为术后第2年至第3年,以及第5年至第6年;多因素分析显示HER-2状态是局部复发的独立影响因素.结论 保乳治疗后出现两个局部复发高峰时间段,HER-2表达状态是局部复发的独立影响因素,对于具有高危因素的患者需更积极治疗. Objective To compare and analyze the data of breast caner recurrence after breastconserving therapy ( BCT), and to find high risk factors that can affect local recurrence. Methods A total of 1034 patients in the data base between January 2000 and June 2008 were analyzed retrospectively. The patients aged 23 to 94 years when diagnosed ( median age, 48 years). The data was investigated to compare of two different groups in local recurrence rate and survival rate. The high risk factors of recurrence after BCT [estrogen receptor ( ER )/progesterone receptor ( PR ), human epidermal growth factor receptor ( HER-2 ),age, lymph node involvement, tumor diameter, neoadjuvant chemotherapy, pathological status] were studied. Results The patients were followed-up to June 2010, and the median period was 42 months (range, 3-126 months). During the period, 35 patients developed ipsilateral breast tumor recurrence (3.3%), 47 patients had metastasis to distant organs (4.5%). The 5-year disease-free survival was 87. 7%, 5-year distant disease-free survival was 94. 0%. The lymph node status, HER-2 status and age were significant risk factors for ipsilateral breast tumor recurrence on univariate analysis. One peak recurrence period was from the 2nd to 3rd year, and the other was from the 5th to 6th year after the operation. The HER-2 status was independent factors of ipsilateral breast tumor recurrence on multivariate analysis. Conclusions The recurrence happens primarily in the 2nd to 3rd and the 5th to 6th year after the breast-conserving therapy. HER-2 status is an independent factor of ipsilateral breast tumor recurrence. The patients with high risk factors of recurrence should be treated more aggressively.
出处 《中华外科杂志》 CAS CSCD 北大核心 2010年第24期1851-1854,共4页 Chinese Journal of Surgery
关键词 乳腺肿瘤 复发 保乳治疗 危险因素 Breast neoplasms Recurrence Breast-conserving therapy Risk factors
  • 相关文献

参考文献18

  • 1Early Breast Cancer Trialists' Collaborative Group (EBCTCG).Effect of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival:an overview of the randomized trials.Lancet,2005,366:2087-2106.
  • 2Smith IC,Heys SD,Hutcheon AW,et al.Neoadjuvant chemotherapy in breast cancer:significantly enhanced response with docetaxel.J Clin Oncol,2002,20:1456-1466.
  • 3李金锋,欧阳涛,王天峰,林本耀.95例乳腺癌保乳治疗近期观察[J].中华外科杂志,2004,42(5):282-284. 被引量:28
  • 4Nguyen PL,Taghian AG,Katz MS,et al.Breast cancer subtype approximated by estrogen receptor,progesterone receptor,and HER-2 is associated with local and distant recurrence after breastconserving therapy.J Clin Oncol,2008,26:2373-2378.
  • 5Haffty BG,Yang Q,Reiss M,et al.Locoregional relapse and distant metastesis in conservatively managed triple negative earlystage breast cancer.J Clin Oncol,2006,24:5652-5657.
  • 6Freedman GM,Anderson PR,Li T,et al.Locoregional recurrence of triple-negative breast cancer after breast-conserving surgery and radiation.Cancer,2009,115:946-951.
  • 7Veronesi U,Cascinelli N,Mariani L,et al.Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer.N Engl J Med,2002,347:1227-1232.
  • 8Freedman GM,Hanlon AL,Fowble BL,et al.Recursive partitioning identifies patients at high and low risk for ipsilateral tumor recurrence after breast-conserving surgery and radiation.J Clin Oncol,2002,20:4015-4021.
  • 9Genevieve C,Scott T,Caroline S,et al.Is mastecmoty superior to breast-conserving treatment for young women.Int J Radia Oncol Biol Phys,2007,67:1282-1290.
  • 10Wapnir IL,Anderson SJ,Mamounas EP,et al.Prognosis after Ipsilateral breast tumor recurrence and locoregional recurrences in five national surgical adjuvant breast and bowel project node positive adjuvant breast trial.J Clin Oncol,2006,24:2028-2036.

二级参考文献10

  • 1Yoshifumi Komoike,Kazuyoshi Motomura,Hideo Inaji,Tsutomu Kasugai,Takayuki Nose,Masahiko Koizumi,Hiroki Koyama.Long-term results of breast conserving surgery for stages I and II breast cancer: Experiences at Osaka Medical Center for cancer and cardiovascular diseases[J].Breast Cancer.2002(3)
  • 2KomoikeY,MotomuraK,InajiH ,etal.Long termresultsofbreastconservingsurgeryforstagesⅠandⅡbreastcancer:experiencesatosakamedicalcenterforcancerandcardiovasculardiseases[].BreastCancer.2002
  • 3Fisher B,Anderson S,Redmond C,et al.Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer[].The New England Journal of Medicine.1995
  • 4Veronesi U,Salvadori B,Luini A,et al.Breast conservation is a safe method in patients with small cancer of the breast: long-term results of three randomized trials on 1973 patients[].European Journal of Cancer.1995
  • 5Early Breast Cancer Trailists Collaboration Group.Effects of radiotherapy and surgery in early breast cancer: an overview of the randomized trials[].The New England Journal of Medicine.1995
  • 6Winchester DJ,Menck HR,Winchester DP.The national cancer data base report on the results of a large non-randomized comparison of breast preservation and modified radical mastectomy[].Cancer.1997
  • 7Fisher B,Anderson S,Bryant J,et al.Twenty-year follow up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer[].The New England Journal of Medicine.2002
  • 8Haffty BG,Wilson LD,Smith R,et al.Subareolar breast cancer: longterm results with conservative surgery and radiation therapy[].International Journal of Radiation Oncology Biology Physics.1995
  • 9Gajdos C,Tartter PI,Bleiweiss IJ.Subareolar breast cancer[].The American Journal of Surgery.2000
  • 10Fisher B,Brown A,Mamounas E,et al.Effects of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from national Surgical Adjuvant Breast and Bowel Project B-18[].Journal of Clinical Oncology.1997

共引文献27

同被引文献136

引证文献12

二级引证文献104

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部