Adjuvant treatment results and prognostic factors in patients with stage I-III operated breast cancer

Abstract

OBJECTIVES We evaluated the adjuvant treatment results and prognostic factors in patients with breast cancer. METHODS A total of 197 stage I-III breast cancer patients (mean age 51; range 18 to 80 years) treated and followed up by Okmeydanı Training Hospital, Department of Radiation Oncology in 1995 were evaluated retrospectively. RESULTS The 41.1% of patients were premenopausal and the remaining were postmenopausal. Invasive ductal carcinoma was encountered as the most frequent (85.8%) histopathologic type of tumor and most frequent (%49.7) stage was IIB. Modified radical mastectomy was performed on 65% of patients. In adjuvant treatment, cyclophosphamide- methotrexate-fluorouracil combinations and anthracycline containing combinations were given to 46.7% and 23.4% of patients respectively. In addition, endocrine therapy and radiotherapy was carried out on the 75.6% and 69.0% of patients. Local recurrences was occurred in a rate of 13.2% and distant metastases were observed in a rate of 26.4% and 7.1% of patients had both local recurrences and distant metastases. The 60.9% of patients were disease free and 1% with local recurrences also they were followed-up for a median time of 89 months (4-108). The overall survival rate and disease free survival rates for 5 and 8 years were as follows; 68%, 61%, 66%, and 60% respectively. With one variable analysis increased number of involved axillary lymph nodes, tumor size and stage gave rise to reduced overall survival rate and disease free survival rate. With multiple variable analysis, number of involved axillary lymph nodes (p=0.001) and tumor size (p=0.001) had significant effect on overall survival rate and disease free survival rate. CONCLUSION The tumor size and number of involved axillary lymph nodes were found to be statistically significant prognostic factors in breast cancer patients in our study.

Keywords

• Breast Neoplasms,Neoplasm Staging,Chemotherapy, Adjuvant,Neoplasm Recurrence, Local,Survival Analysis,Retrospective Studies

Evre I-III meme kanserli hastalarda adjuvan tedavi sonuçları ve prognostik faktörler

Öz

AMAÇ Bu çalışmada meme kanserli kadın hastalarda adjuvan tedavi sonuçları ve prognostik faktörler incelendi. GEREÇ VE YÖNTEM 1995 yılında SSK Okmeydanı Eğitim Hastanesi Radyasyon Onkolojisi Kliniği'ne başvuran, tedavi ve takipleri aynı klinikte yapılan, ameliyatlı evre I-III meme kanserli 197 kadın hasta (ort. yaş 51; dağılım 18-80) retrospektif olarak incelendi. BULGULAR Hastaların %41.1'i premenopoze, %58.9'u postmenopoze idi. En sık tümör histolojisi (%85.8) invaziv duktal karsinomdu. En sık evre ise (%49.7) IIB'di. Cerrahi müdahale olarak olguların %65.0'ine modifiye radikal mastektomi yapıldı. Adjuvan tedavi olarak hastaların %46.7'sine siklofosfamid-metotreksat-florourasil kemoterapisi, %23.4'üne antrasiklinli kemoterapi rejimleri uygulandı. Hastaların %75.6'sına hormonoterapi verildi, %69.0'ına radyoterapi uygulandı. Lokal ve bölgesel nüks %13.2 hastada, uzak metastaz %26.4 hastada gelişti. Hastaların %7.1'inde lokal nüks ve uzak metastaz birlikte görüldü. Medyan 89 aylık (4-108) takip sonucu, %60.9'u hastalıksız, %1'i lokal nükslü olarak takibi sürdü. Genel sağkalım oranları 5 yıllık %68, 8 yıllık %61 ve hastalıksız sağkalım 5 yıllık %66, 8 yıllık için ise %60 oldu. Tek değişkenli analizlerde, aksillada tutulan lenf nodu sayısının, tümör boyutunun ve evrenin artması daha kısa genel sağkalım ve hastalıksız sağkalım ile sonuçlandı. Çok değişkenli analizlerde ise aksillada tutulan lenf nodu sayısı (p=0.001) ve tümör boyutu (p=0.001) genel sağkalım ve hastalıksız sağkalımı anlamlı olarak etkilemediği görüldü. SONUÇ Bu çalışmada meme kanserli hastalarda tümör boyutu ve aksillada tutulan lenf nodu sayısı anlamlı oranda prognostik faktörler olarak bulundu.

Anahtar Kelimeler

• Meme kanseri, meme kanseri/takip çalışması, kemoterapi, adjuvan, neoplazi nüks, lokal/önleme ve kontrol, sa¤kal›m çalışması.

Kaynakça

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