Aggressive Surgical Excision of Supraclavicular Lymph Node Did Not Improve the Outcomes of Breast Cancer With Supraclavicular Lymph Node Involvement (KROG 16-14)
- 주제(키워드) Internal mammary node , Non-axillary regional lymph node , Prognostic factors , Radiation therapy , Upfront surgery
- 주제(기타) Oncology
- 설명문(일반) [Kim, Kyubo; Jung, Wonguen] Ewha Womans Univ, Dept Radiat Oncol, Coll Med, Seoul, South Korea; [Kim, Su Ssan; Ahn, Seung Do] Univ Ulsan, Asan Med Ctr, Dept Radiat Oncol, Coll Med, Seoul, South Korea; [Shin, Kyung Hwan; Kim, Jin Ho] Seoul Natl Univ, Dept Radiat Oncol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea; [Choi, Doo Ho; Park, Won] Sungkyunkwan Univ, Samsung Med Ctr, Dept Radiat Oncol, Sch Med, Seoul, South Korea; [Lee, Sun Young] Chonbuk Natl Univ Hosp, Dept Radiat Oncol, Jeonju, South Korea; [Chun, Mison] Ajou Univ, Dept Radiat Oncol, Sch Med, Suwon, South Korea; [Kim, Jin Hee] Keimyung Univ, Dongsan Med Ctr, Dept Radiat Oncol, Sch Med, Daegu, South Korea; [Kim, Yong Bae] Yonsei Univ, Yonsei Canc Ctr, Dept Radiat Oncol, Coll Med, Seoul, South Korea; [Cha, Jihye] Wonju Severance Christian Hosp, Dept Radiat Oncol, Wonju, South Korea; [Park, Hae Jin] Hanyang Univ, Dept Radiat Oncol, Coll Med, Seoul, South Korea; [Lee, Dong Soo] Catholic Univ Korea, Uijeongbu St Marys Hosp, Dept Radiat Oncol, Uijongbu, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 CIG MEDIA GROUP, LP
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000169363
- 본문언어 영어
- Published As https://dx.doi.org/10.1016/j.clbc.2019.09.004
- PubMed https://pubmed.ncbi.nlm.nih.gov/31629642
초록/요약
With the development of imaging technologies, supraclavicular (SCN) and/or internal mammary nodes are increasingly detected in locally advanced breast cancers. The impact of aggressive treatment such as SCN excision was investigated via a large-scale multicenter study. When breast surgery, systemic therapy, and adjuvant radiotherapy were given, SCN excision did not improve locoregional control or survival. Introduction: The purpose of this study was to evaluate the outcomes of upfront surgery followed by radiation therapy (RT) for ipsilateral supraclavicular (SCN) and/or internal mammary (IMN) node-positive breast cancer. Materials and Methods: One hundred fifty-eight patients were included; among these, 91 patients were SCN-positive, 54 were IMN-positive, and 13 were SCN- and IMN-positive. Patients underwent breast conserving surgery (n = 74) or mastectomy (n = 84) followed by systemic therapy, and adjuvant RT to whole breast/chest wall with or without regional nodal RT. Regarding regional treatments for SCN and IMN, SCN excision was performed in 59 (37.3%) patients, IMN excision in 10 (6.3%) patients, SCN RT in 143 (90.5%) patients, and IMN RT in 68 (43.0%) patients. Results: The median duration of follow-up was 72 months (range, 7-182 months). There were 20 locoregional recurrences and 45 distant metastases. In-field failure was observed only in SCN (n = 8), and 6 of these patients initially underwent SCN excision. The 5-year locoregional recurrence-free survival, disease-free survival (DFS), and overall survival rates were 87.3%, 71.6%, and 89.7%, respectively. Neither SCN excision nor SCN RT dose >= 54 Gy improved locoregional control (P = .927 and P = .693, respectively) or DFS (P = .394 and P = .686, respectively). Having >= 10 involved axillary lymph nodes was the only independent prognosticator for DFS after adjusting for covariates (P = .003). Conclusion: Regional control rate in initially involved SCN and/or IMN was acceptable in patients treated with upfront surgery followed by systemic therapy plus adjuvant RT. More aggressive regional therapy such as SCN excision did not improve locoregional control or survival.
more