TY - JOUR
T1 - Locoregional recurrence patterns after mastectomy and doxorubicin-based chemotherapy
T2 - Implications for postoperative irradiation
AU - Katz, Angela
AU - Strom, Eric A.
AU - Buchholz, Thomas A.
AU - Thames, Howard D.
AU - Smith, Cynthia D.
AU - Jhingran, Anuja
AU - Hortobagyi, Gabriel
AU - Buzdar, Aman U.
AU - Theriault, Richard
AU - Singletary, Eva S.
AU - McNeese, McNeese D.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2000
Y1 - 2000
N2 - Purpose: The objective of this study was to determine Iocoregional recurrence (LRR) patterns after mastectomy and doxorubicin-based chemotherapy to define subgroups of patients who might benefit from adjuvant irradiation. Patients and Methods: A total of 1,031 patients were treated with mastectomy and doxorubicin-based chemotherapy without irradiation on five prospective trials. Median follow-up time was 116 months. Rates of isolated and total LRR (± distant metastasis) were calculated by Kaplan-Meier analysis. Results: The 10-year actuarial rates of isolated LRR were 4%, 10%, 21%, and 22% for patients with zero, one to three, four to nine, or ≥ 10 involved nodes, respectively (P < .0001). Chest wall (68%) and supraclavicular nodes (41%) were the most common sites of LRR. T stage (P < .001), tumor size (P < .001), and ≥ 2-mm extranodal extension (P < .001) were also predictive of LRR. Separate analysis was performed for patients with T1 or T2 primary disease and one to three involved nodes (n = 404). Those with fewer than 10 nodes examined were at increased risk of LRR compared wth those with ≥ 10 nodes examined (24% v 11%; P= .02). Patients with tumor size greater than 4.0 cm or extranodal extension ≥ 2 mm experienced rates of isolated LRR in excess of 20%. Each of these factors continued to significantly predict for LRR in multivariate analysis by Cox logistic regression. Conclusion: Patients with tumors ≥ 4 cm or at least four involved nodes experience LRR rates in excess of 20% and should be offered adjuvant irradiation. Additionally, patients with one to three involved nodes and large tumors, extranodal extension ≥ 2 mm, or inadequate axillary dissections experience high rates of LRR and may benefit from postmastectomy irradiation. (C) 2000 by American Society of Clinical Oncology.
AB - Purpose: The objective of this study was to determine Iocoregional recurrence (LRR) patterns after mastectomy and doxorubicin-based chemotherapy to define subgroups of patients who might benefit from adjuvant irradiation. Patients and Methods: A total of 1,031 patients were treated with mastectomy and doxorubicin-based chemotherapy without irradiation on five prospective trials. Median follow-up time was 116 months. Rates of isolated and total LRR (± distant metastasis) were calculated by Kaplan-Meier analysis. Results: The 10-year actuarial rates of isolated LRR were 4%, 10%, 21%, and 22% for patients with zero, one to three, four to nine, or ≥ 10 involved nodes, respectively (P < .0001). Chest wall (68%) and supraclavicular nodes (41%) were the most common sites of LRR. T stage (P < .001), tumor size (P < .001), and ≥ 2-mm extranodal extension (P < .001) were also predictive of LRR. Separate analysis was performed for patients with T1 or T2 primary disease and one to three involved nodes (n = 404). Those with fewer than 10 nodes examined were at increased risk of LRR compared wth those with ≥ 10 nodes examined (24% v 11%; P= .02). Patients with tumor size greater than 4.0 cm or extranodal extension ≥ 2 mm experienced rates of isolated LRR in excess of 20%. Each of these factors continued to significantly predict for LRR in multivariate analysis by Cox logistic regression. Conclusion: Patients with tumors ≥ 4 cm or at least four involved nodes experience LRR rates in excess of 20% and should be offered adjuvant irradiation. Additionally, patients with one to three involved nodes and large tumors, extranodal extension ≥ 2 mm, or inadequate axillary dissections experience high rates of LRR and may benefit from postmastectomy irradiation. (C) 2000 by American Society of Clinical Oncology.
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U2 - 10.1200/JCO.2000.18.15.2817
DO - 10.1200/JCO.2000.18.15.2817
M3 - Article
C2 - 10920129
AN - SCOPUS:0033898756
SN - 0732-183X
VL - 18
SP - 2817
EP - 2827
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 15
ER -