A. Zikiryahodjaev, M. Ermoshchenkova, A. Bosieva, J. F. Omarova, N. Volchenko, I. Reshetov
{"title":"保乳手术及乳腺癌综合治疗后局部无复发生存率","authors":"A. Zikiryahodjaev, M. Ermoshchenkova, A. Bosieva, J. F. Omarova, N. Volchenko, I. Reshetov","doi":"10.47093/2218-7332.2021.12.1.30-38","DOIUrl":null,"url":null,"abstract":"Aim. To determine the frequency of local recurrence of breast cancer (BC) after performing breast-conserving surgery (BCS) during and after complex treatment, to study the risk factors for local recurrence and survival.Materials and methods. A retrospective cohort study of 675 patients with breast cancer who underwent BCS followed by remote radiotherapy was conducted. The frequency of local relapse and risk factors were studied, 3- and 5-year local-free survival. The odds ratios (OR) and 95% confidence intervals (CI) were calculated, and the Kaplan–Meyer curves were constructed.Results. Radical breast resections (RBR) were performed in 46.7% of patients, and oncoplastic breast resections (OBS) in 53.3% of patients. The most common histological type in both groups was invasive cancer with no signs of specificity: 76.9% and 84.1% – in the OBS and RBR groups, respectively. The incidence of cancer in situ was higher in the OBS group: 14.7% vs. 3.3% in the RBR group (p < 0.001), metastases in regional lymph nodes were more frequent in the RBR group: 34.3% against 20.3% in OBS (p < 0.001). According to the immunohistochemical type and degree of differentiation, the groups did not differ. For 3 years, the relapse-free survival rate was 99.7% in both groups, and for 5 years – 99.2% in the OBS group. and 99.7% in the RBR group, 6 years – 98.3% and 98.7%, respectively; no significant differences were found between the groups. There were no statistically significant differences in the frequency of relapses depending on the width of the resection edges from <1 to ≥10 mm. The risk of relapse was increased with a preserved menstrual status (OR 20.05; 95% CI 2.52–159.33), Her2/neu–positive (OR 5.11; 95% CI 1.04–25.09) and triple-negative types (OR 4.02; 95% CI 1.02–15.95), the degree of differentiation of G3 (OR 5.58; 95% CI 1.59–19.64).Conclusion. BCS is characterized by oncological safety; the rate of local relapse within 6 years is 1.5%. Risk factors for relapse include active menstrual status, highly aggressive immunohistochemical types of breast cancer, and low degree of differentiation.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"63 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Local-free recurrence survival after breast-conserving surgery and the breast cancer complex treatment\",\"authors\":\"A. Zikiryahodjaev, M. Ermoshchenkova, A. Bosieva, J. F. Omarova, N. Volchenko, I. Reshetov\",\"doi\":\"10.47093/2218-7332.2021.12.1.30-38\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim. To determine the frequency of local recurrence of breast cancer (BC) after performing breast-conserving surgery (BCS) during and after complex treatment, to study the risk factors for local recurrence and survival.Materials and methods. A retrospective cohort study of 675 patients with breast cancer who underwent BCS followed by remote radiotherapy was conducted. The frequency of local relapse and risk factors were studied, 3- and 5-year local-free survival. The odds ratios (OR) and 95% confidence intervals (CI) were calculated, and the Kaplan–Meyer curves were constructed.Results. Radical breast resections (RBR) were performed in 46.7% of patients, and oncoplastic breast resections (OBS) in 53.3% of patients. The most common histological type in both groups was invasive cancer with no signs of specificity: 76.9% and 84.1% – in the OBS and RBR groups, respectively. The incidence of cancer in situ was higher in the OBS group: 14.7% vs. 3.3% in the RBR group (p < 0.001), metastases in regional lymph nodes were more frequent in the RBR group: 34.3% against 20.3% in OBS (p < 0.001). According to the immunohistochemical type and degree of differentiation, the groups did not differ. For 3 years, the relapse-free survival rate was 99.7% in both groups, and for 5 years – 99.2% in the OBS group. and 99.7% in the RBR group, 6 years – 98.3% and 98.7%, respectively; no significant differences were found between the groups. There were no statistically significant differences in the frequency of relapses depending on the width of the resection edges from <1 to ≥10 mm. The risk of relapse was increased with a preserved menstrual status (OR 20.05; 95% CI 2.52–159.33), Her2/neu–positive (OR 5.11; 95% CI 1.04–25.09) and triple-negative types (OR 4.02; 95% CI 1.02–15.95), the degree of differentiation of G3 (OR 5.58; 95% CI 1.59–19.64).Conclusion. BCS is characterized by oncological safety; the rate of local relapse within 6 years is 1.5%. Risk factors for relapse include active menstrual status, highly aggressive immunohistochemical types of breast cancer, and low degree of differentiation.\",\"PeriodicalId\":129151,\"journal\":{\"name\":\"Sechenov Medical Journal\",\"volume\":\"63 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sechenov Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.47093/2218-7332.2021.12.1.30-38\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sechenov Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.47093/2218-7332.2021.12.1.30-38","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
的目标。目的:探讨保乳手术(breast- conservation surgery, BCS)患者在复杂治疗期间及术后局部复发的频率,探讨局部复发及生存的危险因素。材料和方法。回顾性队列研究675例接受BCS和远程放疗的乳腺癌患者。研究局部复发频率和危险因素,3年和5年局部无生存期。计算优势比(OR)和95%置信区间(CI),并构建Kaplan-Meyer曲线。46.7%的患者行根治性乳房切除术(RBR), 53.3%的患者行癌性乳房切除术(OBS)。两组中最常见的组织学类型是浸润性癌症,无特异性征象:在OBS组和RBR组中分别为76.9%和84.1%。原位癌在OBS组的发生率更高:14.7% vs. RBR组的3.3% (p < 0.001),区域淋巴结转移在RBR组更常见:34.3% vs. OBS的20.3% (p < 0.001)。免疫组化分型及分化程度各组无差异。两组3年无复发生存率为99.7%,OBS组5年无复发生存率为99.2%。RBR组为99.7%,6年分别为98.3%和98.7%;两组间未发现显著差异。在<1至≥10 mm的切除边缘宽度范围内,复发频率无统计学差异。保留月经状态会增加复发的风险(OR 20.05;95% CI 2.52-159.33), Her2/ new阳性(OR 5.11;95% CI 1.04-25.09)和三阴性型(OR 4.02;95% CI 1.02-15.95), G3分化程度(OR 5.58;95% CI 1.59-19.64)。BCS具有肿瘤安全性;6年内局部复发率为1.5%。复发的危险因素包括活跃的月经状态、高度侵袭性的免疫组织化学类型乳腺癌和低分化程度。
Local-free recurrence survival after breast-conserving surgery and the breast cancer complex treatment
Aim. To determine the frequency of local recurrence of breast cancer (BC) after performing breast-conserving surgery (BCS) during and after complex treatment, to study the risk factors for local recurrence and survival.Materials and methods. A retrospective cohort study of 675 patients with breast cancer who underwent BCS followed by remote radiotherapy was conducted. The frequency of local relapse and risk factors were studied, 3- and 5-year local-free survival. The odds ratios (OR) and 95% confidence intervals (CI) were calculated, and the Kaplan–Meyer curves were constructed.Results. Radical breast resections (RBR) were performed in 46.7% of patients, and oncoplastic breast resections (OBS) in 53.3% of patients. The most common histological type in both groups was invasive cancer with no signs of specificity: 76.9% and 84.1% – in the OBS and RBR groups, respectively. The incidence of cancer in situ was higher in the OBS group: 14.7% vs. 3.3% in the RBR group (p < 0.001), metastases in regional lymph nodes were more frequent in the RBR group: 34.3% against 20.3% in OBS (p < 0.001). According to the immunohistochemical type and degree of differentiation, the groups did not differ. For 3 years, the relapse-free survival rate was 99.7% in both groups, and for 5 years – 99.2% in the OBS group. and 99.7% in the RBR group, 6 years – 98.3% and 98.7%, respectively; no significant differences were found between the groups. There were no statistically significant differences in the frequency of relapses depending on the width of the resection edges from <1 to ≥10 mm. The risk of relapse was increased with a preserved menstrual status (OR 20.05; 95% CI 2.52–159.33), Her2/neu–positive (OR 5.11; 95% CI 1.04–25.09) and triple-negative types (OR 4.02; 95% CI 1.02–15.95), the degree of differentiation of G3 (OR 5.58; 95% CI 1.59–19.64).Conclusion. BCS is characterized by oncological safety; the rate of local relapse within 6 years is 1.5%. Risk factors for relapse include active menstrual status, highly aggressive immunohistochemical types of breast cancer, and low degree of differentiation.