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Comparison of breast conserving surgery followed by radiation therapy with mastectomy alone for pathologic N1 breast cancer patients in the era of anthracycline plus taxane-based chemotherapy: A multicenter retrospective study (KROG 1418)

Title
Comparison of breast conserving surgery followed by radiation therapy with mastectomy alone for pathologic N1 breast cancer patients in the era of anthracycline plus taxane-based chemotherapy: A multicenter retrospective study (KROG 1418)
Authors
Yoo G.S.Park W.Yu J.I.Choi D.H.Kim Y.-J.Shin K.H.Wee C.W.Kim K.Park K.R.Kim Y.B.Ahn S.J.Lee J.H.Kim J.H.Chun M.Lee H.-S.Kim J.S.Cha J.
Ewha Authors
김규보
SCOPUS Author ID
김규보scopus
Issue Date
2019
Journal Title
Cancer Research and Treatment
ISSN
1598-2998JCR Link
Citation
Cancer Research and Treatment vol. 51, no. 3, pp. 1041 - 1051
Keywords
AnthracyclinesBreast conserving surgeryBreast neoplasmsMastectomyPathologic N1RadiotherapySurvivalTaxane
Publisher
Korean Cancer Association
Indexed
SCIE; SCOPUS; KCI WOS scopus
Document Type
Article
Abstract
Purpose We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy. Materials and Methods We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups. Results The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly. Conclusion There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III. Copyright © 2019 by the Korean Cancer Association This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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DOI
10.4143/crt.2018.424
Appears in Collections:
의과대학 > 의학과 > Journal papers
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