Long-Term Survival Outcomes and Risk Factors for Axillary and Locoregional Recurrence in Japanese Patients with Sentinel Node-Positive Breast Cancer Treated in Accordance with the ACOSOG Z0011 Strategy.

IF 2.5 3区医学 Q3 ONCOLOGY Oncology Pub Date : 2024-08-19 DOI:10.1159/000540363

Yuri Oyama, Nobuyoshi Kittaka, Ayako Higuchi, Yusa Togashi, Azusa Taniguchi, Yukiko Seto, Ai Soma, Sungae Park, Jun Okuno, Noriyuki Watanabe, Saki Matsui, Mikiya Ishihara, Minako Nishio, Keiichiro Honma, Takahiro Nakayama

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Abstract

Introduction: In 2018, we reported the results of a study to assess the feasibility of applying the ACOSOG Z0011 criteria to Japanese patients with early-stage breast cancer (median follow-up, 3 years). Their results over the longer term can now be presented. Risk factors for axillary and locoregional recurrence in Z0011-eligible patients are unknown.

Methods: Long-term survival outcomes were investigated by analyzing data from patients enrolled in the feasibility study. Data from the feasibility study patients, and from patients eligible for the Z0011 strategy after its introduction into clinical practice, were subjected to multivariate logistic regression analysis to identify risk factors for axillary and locoregional recurrence.

Results: Regarding long-term outcomes for the feasibility study patients (n = 189), distant disease-free survival rates at 5 and 7 years were 90.4 ± 2.1% and 85.9 ± 2.6%, respectively, and overall survival rates at 5 and 7 years were 97.3 ± 1.2% and 95.3 ± 1.7%, respectively. Analysis of data from these patients plus the 93 who received Z0011 in clinical practice (total, n = 282) identified the following independent risk factors for axillary recurrence: absence of high axillary tangential irradiation (OR, 5.87 [95% CI, 1.09-31.35], p = 0.04) and number of positive sentinel lymph nodes (OR, 4.65 [95% CI, 1.11-19.48], p = 0.04). Only high Ki67 labeling index (OR, 5.92 [95% CI, 1.31-26.70], p = 0.02) was identified as an independent risk factor for locoregional recurrence.

Conclusion: Long-term survival outcome results of the feasibility study show that the Z0011 strategy can be used to treat Japanese patients with early-stage breast cancer. Our findings regarding risk factors suggest that high axillary tangent irradiation is necessary for the prevention of axillary recurrence and that irradiation, including of the regional lymph nodes, should be considered, especially in patients with high Ki67 index values.

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按照 ACOSOG Z0011 策略治疗的日本前哨节点阳性乳腺癌患者的长期生存结果及腋窝和局部复发的风险因素。

导言：2018 年，我们报告了一项研究的结果，该研究旨在评估将 ACOSOG Z0011 标准应用于日本早期乳腺癌患者（中位随访 3 年）的可行性。现在我们可以介绍其长期结果。符合Z0011标准的患者腋窝和局部复发的风险因素尚不清楚：方法：通过分析参加可行性研究的患者数据，对长期生存结果进行了调查。对来自可行性研究患者的数据以及Z0011策略引入临床实践后符合条件的患者数据进行多变量逻辑回归分析，以确定腋窝和局部复发的风险因素：关于可行性研究患者（n = 189）的长期结果，5年和7年的远处无病生存率分别为（90.4 ± 2.1%）和（85.9 ± 2.6%），5年和7年的总生存率分别为（97.3 ± 1.2%）和（95.3 ± 1.7%）。对这些患者的数据以及在临床实践中接受Z0011治疗的93例患者（共282例）的数据进行分析后发现，腋窝复发的独立风险因素如下：未接受腋窝切向照射（OR，5.87 [95% CI，1.09-31.35]，P = 0.04）和前哨淋巴结阳性数量（OR，4.65 [95% CI，1.11-19.48]，P = 0.04）。只有高Ki67标记指数（OR，5.92 [95% CI，1.31-26.70]，p = 0.02）被确定为局部复发的独立危险因素：可行性研究的长期生存结果表明，Z0011策略可用于治疗日本早期乳腺癌患者。我们关于风险因素的研究结果表明，高腋窝切线照射对于预防腋窝复发是必要的，而且应考虑包括区域淋巴结在内的照射，尤其是对于Ki67指数值较高的患者。

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.