유방암의 유방절제술 후 발생한 국소 및 구역에 국한된 재발의 수술적 치료에 따른 이차적 재발 양상과 예후 인자 분석
Pattern of Secondary Failure and Prognostic Factors for Survival Following Surgical Treatment of Isolated Locoregional Recurrence after Mastectomy of Breast Cancer
손병호, 홍성희, 강희준, 윤호성, 안세현,
소속 상세정보
손병호 ( Son Byung-Ho )
울산대학교 의과대학 외과학교실
홍성희 ( Hong Seong-Hee )
울산대학교 의과대학 외과학교실
강희준 ( Kang Hee-Joon )
울산대학교 의과대학 외과학교실
윤호성 ( Yoon Ho-Sung )
울산대학교 의과대학 외과학교실
안세현 ( Ahn Sei-Hyun )
울산대학교 의과대학 외과학교실
KMID : 0371320030640040282
Abstract
PURPOSE: This study was performed to evaluate the patterns of secondary failure, and the prognostic factors for survival, following surgical treatment of an isolated locoregional recurrence after a mastectomy in breast cancer patients.
METHODS: Forty-nine patients, who had undergone an excision, or a wide excision, either with or without radiation therapy, for an isolated locoregional recurrence following a mastectomy, between 1991 and 2001, were retrospectively analyzed according to the secondary recurrence patterns, the time to the secondary failure, survival rate, and prognostic factors for survival.
RESULTS: During the 33 month median follow-up, 28 patients (57%) developed a secondary recurrence; an isolated locoregional failure in 7 (25%), a systemic dissemination in 20 (71%), and both in 1 (4%). The median times from the first recurrence to the second failure, according to the pattern of the secondary failure, were 16, 14 and 6 months for locoregional, for systemic dissemination, and for both, respectively. The disease-free interval (DFI) from first surgery to the recurrence was a significant independent prognostic factor for the second failure. A Univariate analysis identified the DFI, and hormone therapy administered due to a recurrence, as significant prognostic factors for overall survival, but these were not from a multivariate analysis. The 5-year disease-free and overall survival rates for an isolated locoregional recurrence were 27% and 79%, respectively, compared with 0% for both these rates for a recurrence combined with a systemic recurrence (P=0.002).
CONCLUSION: A secondary failure, following treatment of an isolated locoregional recurrence, developed in more than half the patients, with a locoregional failure in 25%, and a systemic dissemination in the remainder. DFI and hormone therapy for a recurrence were independent prognostic factors of the overall survival. The survival rates after surgical treatment of isolated locoregional recurrences were increased compared with those for a recurrence combined with a systemic recurrence.
키워드
유방암;국소 및 구역 재발;수술적 치료;이차적 재발;예후인자
Breast cancer;Locoregional recurrence;Surgical treatment;Secondary failure;Prognostic factors
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