Post-mastectomy radiotherapy benefits subgroups of breast cancer patients with T1-2 tumor and 1–3 axillary lymph node(s) metastasis
Online veröffentlicht: 10. Juli 2014
Seitenbereich: 314 - 322
Eingereicht: 26. Juli 2013
Akzeptiert: 20. Okt. 2013
DOI: https://doi.org/10.2478/raon-2013-0085
Schlüsselwörter
© by Kun-Ming Rau
This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. To determine the role of postmastectomy radiotherapy (PMRT) in breast cancer patients with T1-2 and N1 disease.
Patients and methods. A total of 207 postmastectomy women were enrolled. The 5-year Kaplan-Meier estimates of locoregional recurrence rate (LRR), distant recurrence rate (DRR) and overall survival (OS) were analyzed by different tumor characteristics. Multivariate analyses were performed using Cox proportional hazards modeling.
Results. With median follow-up 59.5 months, the 5-year LRR, DRR and OS were 9.1%, 20.3% and 84.4%, respectively. On univariate analysis, age < 40 years old (p = 0.003) and Her-2/neu over-expression (p = 0.016) were associated with higher LRR, whereas presence of LVI significantly predicted higher DRR (p = 0.026). Negative estrogen status (p = 0.033), Her-2/neu overexpression (p = 0.001) and LVI (p = 0.01) were significantly correlated with worse OS. PMRT didn’t prove to reduce 5-year LRR (p = 0.107), as well as 5-year OS (p = 0.918). In subgroup analysis, PMRT showed significant benefits of improvement LRR and OS in patients with positive LVI.
Conclusions. For patients with T1-2 and N1 stage breast cancer, PMRT can decrease locoregional recurrence and increase overall survival only in patients with lymphovascular invasion.