Breast conservative therapy in east part of China: a retrospective cohort study

Jiang, Fan; Wang, Lei; Wang, Xiao Jin; Wu, Jiong; Lu, Junyan; Di, Gen-Hong; Shen, Kun Wei; Han, Qi; Liu, Bang Ling; Shen, Zhen; Shao, Zhi Ming

doi:10.1007/s00432-006-0104-x

Cited by 10 publications

(6 citation statements)

References 22 publications

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“…Reduced arm mobility 24,25 Fleissig et al 24 Purushotham et al 8. Local recurrence [27][28][29][30] Veronesi et al 27 Arriagada et al 28 Poggi et al 29 Fisher et al 30 2 561 3 047 43 10 (7 544) [31][32][33][34][35][36][37][38]47,48 12 (12 537) [31][32][33][34][35][36][37][38][39][40][41][42] Pectoral minor dissection v. preservation …”

Section: Comparative Meta-analysis Of Rcts and Nrcts By Topicmentioning

confidence: 99%

Meta-analytic comparison of randomized and nonrandomized studies of breast cancer surgery

Edwards¹,

Kelly²,

Lin³

et al. 2012

Can J Surg

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Meta-analytic comparison of randomized and nonrandomized studies of breast cancer surgeryBackground: Randomized controlled trials (RCTs) are thought to provide the most accurate estimation of "true" treatment effect. The relative quality of effect estimates derived from nonrandomized studies (nRCTs) remains unclear, particularly in surgery, where the obstacles to performing high-quality RCTs are compounded. We performed a meta-analysis of effect estimates of RCTs comparing surgical procedures for breast cancer relative to those of corresponding nRCTs.Methods: English-language RCTs of breast cancer treatment in human patients published from 2003 to 2008 were identified in MEDLINE, EMBASE and Cochrane databases. We identified nRCTs using the National Library of Medicine's "related articles" function and reference lists. Two reviewers conducted all steps of study selection. We included studies comparing 2 surgical arms for the treatment of breast cancer. Information on treatment efficacy estimates, expressed as relative risk (RR) for outcomes of interest in both the RCTs and nRCTs was extracted. Results:We identified 12 RCTs representing 10 topic/outcome combinations with comparable nRCTs. On visual inspection, 4 of 10 outcomes showed substantial differences in summary RR. The pooled RR estimates for RCTs versus nRCTs differed more than 2-fold in 2 of 10 outcomes and failed to demonstrate consistency of statistical differences in 3 of 10 cases. A statistically significant difference, as assessed by the z score, was not detected for any of the outcomes. Conclusion:Randomized controlled trials comparing surgical procedures for breast cancer may demonstrate clinically relevant differences in effect estimates in 20%-40% of cases relative to those generated by nRCTs, depending on which metric is used. Contexte :On estime que les essais randomisés et contrôlés (ERC) offrent l'estimation la plus juste de l'effet « réel » des traitements. La qualité relative de l'estimation de l'effet dérivée des études non randomisées (EnRC) reste indéterminée, particulièrement en ce qui concerne la chirurgie, où les obstacles à la réalisation d'ERC optimaux sont nombreux. Nous avons procédé à une méta-analyse des estimations de l'effet dérivées d'ERC qui comparaient des interventions chirurgicales pour le cancer du sein, aux estimations dérivées d'EnRC assortis. Méthodes :Nous avons relevé les ERC sur le traitement du cancer du sein chez l'humain publiés en langue anglaise entre 2003 et 2008 à partir des bases de données MEDLINE, EMBASE et Cochrane. Nous avons relevé les EnRC à l'aide des listes bibliographiques et de la fonction « articles connexes » de la National Library of Medicine. Deux examinateurs se sont chargés de toutes les étapes de la sélection des études. Nous avons inclus les études qui comparaient 2 groupes soumis à une chirurgie pour le traitement du cancer du sein. Nous avons extrait l'information sur les estimations de l'efficacité des traitements, exprimées sous forme de risque relatif (RR) de survenue des paramètres r...

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Section: Comparative Meta-analysis Of Rcts and Nrcts By Topicmentioning

confidence: 99%

Meta-analytic comparison of randomized and nonrandomized studies of breast cancer surgery

Edwards¹,

Kelly²,

Lin³

et al. 2012

Can J Surg

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“…In our hospital, patients eligible for lumpectomy should have a tumor Ͻ4cm in largest diameter, be without palpable axillary lymph nodes on clinical examination, have no absolute contraindication, and be willing to preserve their breast. The preoperative examination and performance of the surgical technique have been described previously [23,24]. All patients having invasive carcinoma or carcinoma in situ with a microinvasion/invasion component undergo a level I and level II axillary lymph node dissection or a sentinel lymph node biopsy.…”

Section: Patientsmentioning

confidence: 99%

“…Lumpectomy patients who were further pathologically proven to have a close (Յ2 mm) or positive margin undergo a secondary mastectomy. For all BCS patients with invasive carcinoma, whole-breast irradiation was given as previously described [23]. Radiotherapy for lumpectomy patients with carcinoma in situ was mainly according to the Van Nuys Prognostic Index [25].…”

Section: Patientsmentioning

confidence: 99%

Different Annual Recurrence Pattern Between Lumpectomy and Mastectomy: Implication for Breast Cancer Surveillance After Breast-Conserving Surgery

Shao

2011

The Oncologist

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Purpose. To investigate the recurrence pattern and annual recurrence risk after breast-conserving surgery and compare them with those after mastectomy.Methods. This retrospective analysis included 6,135 consecutive unilateral breast cancer patients undergoing surgery in 1998 -2008, with 847 lumpectomy patients and 5,288 mastectomy patients. Recurrence patterns were scrutinized and annual recurrence rates were calculated. Furthermore, a literature-based review including seven relevant studies was subsequently performed to confirm our single-institution data-based observations.Results. After lumpectomy, 50.9% of recurrences occurred within 3 years and 30.2% of recurrences were detected at 3-5 years; after mastectomy, 64.9% of recurrences occurred within 3 years and 20.4% occurred at 3-5 years. The major locoregional recurrence pattern after lumpectomy was ipsilateral breast tumor recurrence, which mainly (81.3%) occurred <5 years postsurgery but with a low incidence of 37.5% <3 years postsurgery. Annual recurrence curves indicated that the relapse peak after mastectomy emerged in the first 2 years; however, recurrence after lumpectomy increased annually with the highest peak near 5 years. By reviewing relevant studies, we confirmed our finding of different annual recurrence patterns for lumpectomy and mastectomy patients. The hazard ratio of dying for those recurring <5 years postlumpectomy relative to patients relapsing >5 years postlumpectomy was 4.62 (95% confidence interval, 1.05-20.28; p ‫؍‬ .042).Conclusions. Different recurrence patterns between mastectomy and lumpectomy patients imply that scheduling of surveillance visits should be more frequent during the 4 -6 years after lumpectomy. Further prospective trials addressing the necessity of frequent and longer surveillance after lumpectomy are warranted. The

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“…The procedure of the BCS technique in our center was described previously ( 10 , 11 ). Before 2010, the frozen section analysis (FSA) was utilized intraoperatively to evaluate breast margin in our center.…”

Section: Methodsmentioning

confidence: 99%

Spatiotemporal Patterns of Loco-Regional Recurrence After Breast-Conserving Surgery

Mao

Liu

et al. 2021

Front. Oncol.

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BackgroundLoco-regional recurrences (LRR) following breast-conserving surgery (BCS) remain a heterogeneous class of disease that has significant variation in its biological behavior and prognosis.MethodsTo delineate the spatiotemporal patterns of LRR after BCS, we analyzed the data of 4325 patients treated with BCS from 2006 to 2016. Clinico-pathological and treatment specific factors were analyzed using the Cox proportional hazards model to identify factors predictive for LRR events. Recurrence patterns were scrutinized based on recurrence type and recurrence-free interval (RFI). Annual recurrence rates (ARR) were compared according to recurrence type and molecular subtype.ResultsWith a median follow-up of 66 months, 120 (2.8%) LRRs were recorded as the first site of failure. Age, pathologic stage, and molecular subtype were identified as predictors of LRR. The major recurrence type was ipsilateral breast tumor recurrence, which mainly (83.6%) occurred ≤5y post surgery. In the overall population, ARR curves showed that relapse peaked in the first 2.5 years. Patients with regional nodal recurrence, shorter RFI, and synchronous distant metastasis were associated with a poorer prognosis. HER2-positive disease had a higher rate of LRR events, more likely to have in-breast recurrence, and had an earlier relapse peak in the first 2 years after surgery.ConclusionsLRR risk following BCS is generally low in Chinese ethnicity. Different recurrence patterns after BCS were related to distinct clinical outcomes. Management of LRR should be largely individualized and tailored to the extent of disease, the molecular profile of the recurrence, and to baseline clinical variables.

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Breast conservative therapy in east part of China: a retrospective cohort study

Cited by 10 publications

References 22 publications

Meta-analytic comparison of randomized and nonrandomized studies of breast cancer surgery

Meta-analytic comparison of randomized and nonrandomized studies of breast cancer surgery

Different Annual Recurrence Pattern Between Lumpectomy and Mastectomy: Implication for Breast Cancer Surveillance After Breast-Conserving Surgery

Spatiotemporal Patterns of Loco-Regional Recurrence After Breast-Conserving Surgery

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