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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2009

Open Access 01-12-2009 | Breast Oncology

Prognostic Factors in 77 Curative Chest Wall Resections for Isolated Breast Cancer Recurrence

Authors: Carmen C. van der Pol, MD, Albertus N. van Geel, MD, PhD, Marian B. E. Menke-Pluymers, MD, PhD, Paul I. M. Schmitz, PhD, Titia E. Lans, MD, PhD

Published in: Annals of Surgical Oncology | Issue 12/2009

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Abstract

Background

Full-thickness chest wall resection (CWR) is the preferred treatment for breast cancer (BC) patients with extensive isolated locoregional recurrence. It remains a challenge to select patients that will benefit most from this treatment. The aim of this study was to define prognostic factors in patients who undergo CWR with curative intent.

Methods

BC patients who underwent a CWR with curative intent for recurrence of disease between 1986 and 2006 were included in this retrospective study. Twenty-two factors were studied in a univariate analyses, and multivariate stepwise Cox regression analyses was performed.

Results

Seventy-seven patients were included in this study. The 5-year overall survival was 25%. There was one postoperative death. Univariate analyses showed that three prognostic factors were significantly correlated with OS and disease-free survival: (1) interval between primary treatment and CWR (P = .02 and .004, respectively), (2) chemotherapy for recurrence (P = .05 and .05, respectively), and (3) resection specimen smaller than 150 cm2 (P = .03 and .009, respectively). An interval lasting >10 years between primary treatment and CWR remained statistically significantly correlated with better overall survival and disease-free survival after multivariate analyses.

Conclusions

CWR is a safe treatment in patients who have isolated extensive BC recurrence. The best survival outcome was seen in patients after a disease-free interval of ≥10 years. Existing data show that adjuvant radiotherapy and adjuvant hormone therapy for estrogen-positive tumors improves overall survival. Neoadjuvant chemotherapy may be considered in individual patients.
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Metadata
Title
Prognostic Factors in 77 Curative Chest Wall Resections for Isolated Breast Cancer Recurrence
Authors
Carmen C. van der Pol, MD
Albertus N. van Geel, MD, PhD
Marian B. E. Menke-Pluymers, MD, PhD
Paul I. M. Schmitz, PhD
Titia E. Lans, MD, PhD
Publication date
01-12-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 12/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0662-7

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