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Prognostic factors for recurrent breast cancer patients with an isolated, limited number of lung metastases and implications for pulmonary metastasectomy

Cited 35 time in Web of Science Cited 40 time in Scopus
Authors
Yhim, Ho-Young; Han, Sae-Won; Oh, Do-Youn; Han, Wonshik; Im, Seock-Ah; Kim, Tae-You; Kim, Young Tae; Noh, Dong-Young; Chie, Eui Kyu; Ha, Sung Whan; Park, In Ae; Bang, Yung-Jue
Issue Date
2010-06
Citation
Cancer, Vol.116 No.12, pp.2890-2901
Keywords
breast cancerlung metastasisprognostic factorspulmonary metastasectomy
Abstract
BACKGROUND: The aim of this study was to evaluate the clinical treatment outcomes of recurrent breast cancer with a limited number of isolated lung metastases, and to evaluate the role of pulmonary metastasectorny. METHODS: The authors consecutively enrolled 140 recurrent breast cancer patients with isolated lung metastasis from 1997 to 2007 in Seoul National University Hospital and retrospectively analyzed 45 patients who had <4 metastatic lesions. RESULTS: Fifteen patients had pulmonary metastasectomy followed by systemic treatment (pulmonary metastasectomy group), and 30 received systemic treatment alone (nonpulmonary metastasectomy group). The 3-year progression-free survival (PFS) and 4-year overall survival (OS) was significantly longer in the pulmonary metastasectomy group than in the nonpulmonary metastasectomy group (3-year PFS, 55.0% vs 4.5%, P <.001; 4-year OS, 82.1% vs 31.6%, P = .001). In multivariate analysis, a disease-free interval (DFI) of <24 months (hazard ratio [HP], 4.53; 95% CI, 1.72-11.90), no pulmonary metastasectomy (HR, 9.52; 95% Cl, 3.34-27.18) and biologic subtypes such as human epithelial growth factor receptor-2 positive (HR, 3.00; 95% Cl, 1.04-8.64) and triple negative (HR, 3.92; 95% Cl, 1.32-11.59) were independent prognostic factors for shorter PFS. CONCLUSIONS: The authors' results demonstrated that DFI and biologic subtypes of tumor are firm, independent, prognostic factors for survival, and pulmonary metastasectomy can be a reasonable treatment option in this population. Further prospective studies are warranted to evaluate the role of pulmonary metastasectomy. Cancer 2010;116:2890-901. (C) 2010 American Cancer Society.
ISSN
0008-543X
URI
https://hdl.handle.net/10371/173008
DOI
https://doi.org/10.1002/cncr.25054
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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