*Department of Radiation Oncology,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in Southern China,Guangzhou 510060,ChinaCorresponding authors:Zhang Yujing,Email:zhangyj@sysucc.org.cn;Wen Bixiu,Department of Radiation Oncology,First Affiliated Hospital of Sun yat-sen University,Guangzhou 510080,China;Email:wenbix@mail.sysu.edu.cn
Abstract Objective To explore the predictive value of primary tumor site for loco-regional recurrence (LRR) in early breast cancer patients with one to three positive axillary lymph nodes after radical surgery. Methods The clinical data of 656 patients pathologically diagnosed with pT1-2N1M0 breast cancer who received radical surgery without postoperative radiotherapy in our hospital from 1998 to 2010 were retrospectively analyzed. In those patients, 156 had primary tumor located in the inner quadrant, 45 in the central quadrant, and 455 in the outer quadrant. LRR and local recurrence-free survival (LRFS) were end points. The Kaplan-Meier method was used to estimate LRR and LRFS rates. The log-rank test was used for survival difference analysis and univariate prognostic analysis. Multivariate analysis was performed using the Cox regression model. Results The 5-and 10-year sample sizes were 416 and 191, respectively. The 5-and 10-year LRR rates were 8.6% and 12.9%, respectively, while the 5-and 10-year LRFS rates were 86.2% and 76.4%, respectively. The univariate analysis indicated that age, pT stage, Ki67 level, molecular classification, and primary tumor in the inner quadrant were significant influencing factors for LRR (P=0.000,0.006,0.017,0.004,0.000). The multivariate analysis showed that age no greater than 35 years, primary tumor in the inner quadrant, and non-luminal subtype in molecular classification were independent prognostic factors for LRR and LRFS (P=0.0012,0.012,0.005). With an increasing number of risk factors(≥2), patients with primary tumor in the inner quadrant had a dramatically increased LRR rate and a reduced LRFS rate, while patients with primary tumor in the outer or central quadrant kept the same LRR and LRFS rates. Conclusions The primary tumor site holds promise for prediction of LRR and LRFS in patients with pT1-2N1M0 breast cancer after radical surgery. Patients with primary tumor located in the inner quadrant have a high LRR rate and a low LRFS rate, which provides an excellent predictor for the risk of recurrence in patients with high-risk breast cancer.
Niu Shaoqing*,Wen Ge,Zhang Yujing et al. Prognostic value of primary tumor site in early breast cancer patients with one to three positive axillary lymph nodes after radical surgery[J]. Chinese Journal of Radiation Oncology, 2015, 24(5): 506-510.
Niu Shaoqing*,Wen Ge,Zhang Yujing et al. Prognostic value of primary tumor site in early breast cancer patients with one to three positive axillary lymph nodes after radical surgery[J]. Chinese Journal of Radiation Oncology, 2015, 24(5): 506-510.
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