医学
锁骨上淋巴结
乳腺癌
放射治疗
淋巴结
化疗
病态的
锁骨上窝
放射科
癌症
肿瘤科
外科
内科学
作者
Shuai Li,Shulian Wang,Yongwen Song,Yu Tang,Jing Jin,Weihu Wang,Yueping Liu,Hui Fang,Hua Ren,Jie Wang,Hao Jing,Jianghu Zhang,Qinglin Rong,Shunan Qi,Bo Chen,Ningning Lu,Ning Li,Yu Tang,Xin-Fan Liu,Zihao Yu
标识
DOI:10.3760/cma.j.issn.1004-4221.2019.01.004
摘要
Objective
To investigate the clinical efficacy and prognostic factors of breast cancer patients with ipsilateral supraclavicular lymph node metastasis (ISLNM) receiving neoadjuvant chemotherapy, surgery combined with radiotherapy at diagnosis.
Methods
Therapeutic outcomes of 65 breast cancer patients with ISLNM treated in our hospital between 1999 and 2013 were retrospectively analyzed. All patients were pathologically diagnosed with breast cancer. They were complicated with ISLNM, without distant metastasis confirmed by pathological or imaging examinations. All patients received multi-modality therapy consisting of neoadjuvant chemotherapy, surgery and postoperative radiotherapy. Kaplan-Meier method was adopted to calculate the overall survival (OS), progression-free survival (PFS) and supraclavicular lymph node recurrence (SCFR). The differences between two groups were statistically analyzed by the log-rank test.
Results
The median follow-up time was 66 months (range: 6-137 months). Five patients had SCFR after corresponding treatment. The overall 5-year SCFR, OS and PFS rates were 9.2%, 71.5% and 49.5%, respectively. Following preoperative chemotherapy, the complete response (CR) of supraclavicular lymph node was a prognostic factor affecting OS. The 5-year OS rates in patients with and without CR were 81.4% and 53.9%(P=0.035). The size of supraclavicular lymph node (≤1 cm vs. >1 cm at diagnosis was a risk factor of the SCFR (0% vs. 21.0%, P=0.037) and OS rates (≤1 cm vs. >1 cm: 86.1% vs. 55.6%, P=0.001).
Conclusions
Breast cancer patients with ISLM at diagnosis can obtain high OS rate and excellent tumor control after undergoing multi-modality therapy consisting of preoperative chemotherapy, surgery and postoperative radiotherapy.
Key words:
Breast neoplasms/radiotherapy; Radiotherapy, postoperative; Prognosis
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