期刊
ANNALS OF ONCOLOGY
卷 23, 期 11, 页码 2852-2858出版社
OXFORD UNIV PRESS
DOI: 10.1093/annonc/mds118
关键词
adjuvant treatment; breast cancer; locoregional recurrence; postmastectomy radiotherapy
类别
资金
- Swiss Group for Clinical Cancer Research
- Frontier Science and Technology Research Foundation
- Cancer Council Australia
- Australian New Zealand Breast Cancer Trials Group (National Health Medical Research Council)
- National Institutes of Health [CA-75362]
- Swedish Cancer Society
- Cancer Association of South Africa
- Foundation for Clinical Cancer Research of Eastern Switzerland (OSKK)
Rates and risk factors of local, axillary and supraclavicular recurrences can guide patient selection and target for postmastectomy radiotherapy (PMRT). Local, axillary and supraclavicular recurrences were evaluated in 8106 patients enrolled in 13 randomized trials. Patients received chemotherapy and/or endocrine therapy and mastectomy without radiotherapy. Median follow-up was 15.2 years. Ten-year cumulative incidence for chest wall recurrence of > 15% was seen in patients aged < 40 years (16.1%), with >= 4 positive nodes (16.5%) or 0-7 uninvolved nodes (15.1%); for supraclavicular failures > 10%: >= 4 positive nodes (10.2%); for axillary failures of > 5%: aged < 40 years (5.1%), unknown primary tumor size (5.2%), 0-7 uninvolved nodes (5.2%). In patients with 1-3 positive nodes, 10-year cumulative incidence for chest wall recurrence of > 15% were age < 40, peritumoral vessel invasion or 0-7 uninvolved nodes. Age, number of positive nodes and number of uninvolved nodes were significant parameters for each locoregional relapse site. PMRT to the chest wall and supraclavicular fossa is supported in patients with >= 4 positive nodes. With 1-3 positive nodes, chest wall PMRT may be considered in patients aged < 40 years, with 0-7 uninvolved nodes or with vascular invasion. The findings do not support PMRT to the dissected axilla.
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