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방사선종양학
- 2022년 01월호
[Int J Radiat Oncol Biol Phys.] What Is High-risk Breast Cancer With Pathologically Negative Lymph Nodes for Regional Recurrence? 림프절 음성 유방암 환자에서 영역재발의 고위험군은?아주의대,성균관의대 / 김상원, 조원경, 전미선*, 박원*
- 출처
- Int J Radiat Oncol Biol Phys.
- 등재일
- 2021 Nov 15
- 저널이슈번호
- 111(4):992-998. doi: 10.1016/j.ijrobp.2021.07.005.
- 내용
Abstract
Purpose: This study aimed to identify high-risk factors for regional recurrence in patients with breast cancer with pathologically negative lymph nodes.Methods and materials: We retrospectively analyzed 3800 patients with stage pT1-pT3 breast cancer and pathologically negative lymph nodes between 2004 and 2012. All patients underwent upfront surgery with curative intent. Adjuvant systemic treatments were administered to most patients (96.7%) based on contemporary guidelines.
Results: After a median follow-up of 83 months (range, 7-175 months), the estimated 10-year cumulative incidence rate of regional recurrence was 2.0%. Multivariate competing risk analysis revealed that high histologic grade, positive lymphovascular invasion, and stage pT2-3 were significant risk factors for any regional recurrence. Patients with ≥2 risk factors showed a significantly higher 10-year cumulative incidence rate of any regional recurrence than those with 1 or no risk factors (5.5% vs 1.2%; P < .001). When the number of retrieved lymph nodes was less than 10, the difference in the incidence rate of regional recurrence between patients with ≥2 risk factors and those with 1 or no risk factors was greater (6.6% vs 1.3%, respectively; P < .001). The 10-year disease-free survival was worse in patients with ≥2 risk factors than in those with 1 or no risk factors (84.7% vs 90.0%, respectively; P < .001). Patients with ≥2 risk factors also showed worse 10-year overall survival than did those with 1 or no risk factors (91.3% vs 97.0%, respectively; P < .001).
Conclusions: Overall, the cumulative incidence rate of any regional recurrence was low at 10 years. However, patients with ≥2 risk factors showed an increased risk of any regional recurrence and worse disease-free survival, particularly when the number of retrieved lymph nodes was less than 10.
Affiliations
Sang-Won Kim 1 , Won Kyung Cho 2 , Doo Ho Choi 2 , Haeyoung Kim 2 , Oyeon Cho 3 , Won Park 4 , Mison Chun 5
1 Department of Radiation Oncology, Konyang University College of Medicine, Daejeon, Republic of Korea; Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Republic of Korea.
2 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3 Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
4 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: wonro.park@samsung.com.
5 Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: chunm@ajou.ac.kr.
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림프절 음성 유방암에서 영역림프절 재발의 위험인자를 분석함으로써, 예방적 영역림프절조사의 적응증을 제안하고자 한 연구
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