AI Article Synopsis
- This study investigates factors that predict long-term outcomes for breast cancer patients who experience isolated locoregional recurrence (ILRR) as their first recurrence event, addressing a gap in existing prognostic tools.
- A total of 495 patients were analyzed, focusing on tumor characteristics and patient data, with the study finding that lymph node metastasis, a disease-free interval of less than 30 months, and the type of ILRR significantly influence both distant metastasis-free survival and breast cancer-specific survival.
- The research resulted in a risk stratification system categorizing patients into four risk groups, with varying 5-year post-ILRR distant metastasis-free survival rates, which can guide treatment decisions for better patient management.
Article Abstract
Purpose: This study aimed to identify prognostic factors for long-term outcomes among patients with isolated locoregional recurrence (ILRR) of breast cancer as their first failure event. Many prognostic tools have been developed to inform systemic treatment choices in the adjuvant setting, but tools for predicting post-ILRR prognosis are scarce.
Methods: A total of 495 patients who experienced ILRR after primary surgery at the Asan Medical Center between 1989 and 2008 were included. All patient information and tumor characteristics at the initial surgery were retrieved from our retrospectively collected database, and ILRRs were categorized as local recurrence or regional recurrence (RR). Distant metastasis-free survival (DMFS), breast cancer-specific survival (BCSS), and overall survival post-ILRR were calculated.
Results: The median follow-up from the ILRR was 65 months (range 1-249 months), and the 5-year post-ILRR DMFS rate was 58.9%. We found three factors-lymph node metastasis, a disease-free interval < 30 months, and RR as the ILRR type-that were independent prognostic factors for both DMFS [hazard ratio (HR) = 2.08, 1.60, and 1.59; P < 0.001, 0.002, and 0.003, respectively] and BCSS (HR = 2.28, 1.99, and 1.48; P < 0.001, < 0.001, and 0.016, respectively) post-ILRR. Patients were classified into four groups according to the presence these three prognostic indicators: the low-, intermediate-, high-, and extremely high-risk groups. The 5-year post-ILRR DMFS rates were 79.4%, 68.1%, 47.6%, and 36.0%, respectively.
Conclusions: This risk stratification system for subsequent distant metastases after ILRR can be used to make more informed decisions regarding prognosis-based local or systemic management strategies.
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| http://dx.doi.org/10.1007/s10549-019-05469-5 | DOI Listing |
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