• 作者：Jeong Il Yu¹ ; Won Park¹ ; ^{wonro.park@samsung.com" class="auth_mail" title="E-mail the corresponding author} ; Doo Ho Choi¹ ; Seung Jae Huh¹ ; Seok Jin Nam² ; Seok Won Kim² ; Jeong Eon Lee² ; Won Ho Kil² ; Young-Hyuck Im³ ; Jin Seok Ahn³ ; Yeon Hee Park³ ; Eun Yun Cho⁴
• 关键词：Breast cancer ; N3 ; Prognosis ; Prognostic factor ; Recurrence
• 刊名：Clinical Breast Cancer
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：6
• 页码：512-518
• 全文大小：491 K

Patients and Methods

We performed a retrospective study with 333 pN3 breast cancer patients who received curative surgery with postoperative radiation therapy and taxane-based adjuvant chemotherapy from January 2000 to June 2012. The median follow-up period was 58.3 months (range, 7.4-167.9 months). All of the 243 patients who were hormone receptor-positive received endocrine therapy, and trastuzumab therapy was used in 63 of 88 (71.6%) HER2-positive patients.

Results

Overall, 112 disease recurrences (33.6%) were documented during the follow-up. The first site of recurrence was locoregional in 21 patients (6.3%), distant metastases in 72 patients (21.6%), and both in 19 patients (5.7%). The disease-free survival (DFS) and overall survival were 63.3% and 86.9% at 5 years, respectively. DFS was significantly related to age (> 40 years; P = .008; hazard ratio [HR], 0.59; 95% confidence interval [CI], 0.40-0.87), nuclear grade (I or II; P = .02; HR, 0.64; 95% CI, 0.44-0.93), and positive lymph node ratio (≤ 60%; P = .004; HR, 0.56; 95% CI, 0.38-0.83) in multivariate analysis. HER2-positive patients who were treated with trastuzumab showed more favorable DFS than HER2-negative patients.

Conclusion

More than 60% of the pN3 breast cancer patients treated with the current standard management lived without disease longer than 5 years. Age, nuclear grade, and lymph node ratio were significant prognostic factors in pN3 breast cancer patients.