E Yildirim1. 1. Department of Surgery, Ankara Oncology Training and Research Hospital, Turkey. yildirimemin@yahoo.com
Abstract
AIMS: To assess the risk of locoregional recurrence (LRR) after mastectomy and to identify predictive and treatment factors that affect the risk of LRR. METHODS: The primary endpoint was local recurrence. Univariate and multivariate Cox regression analyses were carried out in the data from 1217 patients. RESULTS: The median follow-up was 74 months, and 63 (5.2%) patients experienced a LRR in their follow-up period. In the multivariate analysis, age group (< or =35 years vs. >35 years, p<0.0001; Hazard Ratio [HR], 5.0; 95% Confidence Interval [95% CI], 3.0-8.3), tumour size (>2 cm vs. < or =2 cm, p=0.03; HR, 2.2; 95% CI, 1.2-4.7) and LVI (yes vs. no, p<0.0001; HR, 3.2; 95% CI,1.9-5.2) were the independent prognostic factors for LRR. This analysis, in the final model, indicated that adjuvant radiotherapy and adjuvant tamoxifen were associated with a reduced risk of LRR by 90% and 75%, respectively, across the follow-up period, whereas age group remained as an important risk factor (p=0.002; HR, 3.0; 95% CI, 1.5-6.2). CONCLUSIONS: Although adjuvant therapies reduce the risk of LRR, young age is an independent risk factor for LRR.
AIMS: To assess the risk of locoregional recurrence (LRR) after mastectomy and to identify predictive and treatment factors that affect the risk of LRR. METHODS: The primary endpoint was local recurrence. Univariate and multivariate Cox regression analyses were carried out in the data from 1217 patients. RESULTS: The median follow-up was 74 months, and 63 (5.2%) patients experienced a LRR in their follow-up period. In the multivariate analysis, age group (< or =35 years vs. >35 years, p<0.0001; Hazard Ratio [HR], 5.0; 95% Confidence Interval [95% CI], 3.0-8.3), tumour size (>2 cm vs. < or =2 cm, p=0.03; HR, 2.2; 95% CI, 1.2-4.7) and LVI (yes vs. no, p<0.0001; HR, 3.2; 95% CI,1.9-5.2) were the independent prognostic factors for LRR. This analysis, in the final model, indicated that adjuvant radiotherapy and adjuvant tamoxifen were associated with a reduced risk of LRR by 90% and 75%, respectively, across the follow-up period, whereas age group remained as an important risk factor (p=0.002; HR, 3.0; 95% CI, 1.5-6.2). CONCLUSIONS: Although adjuvant therapies reduce the risk of LRR, young age is an independent risk factor for LRR.
Authors: Rick G Pleijhuis; Maurits Graafland; Jakob de Vries; Joost Bart; Johannes S de Jong; Gooitzen M van Dam Journal: Ann Surg Oncol Date: 2009-07-17 Impact factor: 5.344