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Effect of Postoperative Radiotherapy after Primary Tumor Resection in De Novo Stage IV Breast Cancer: A Multicenter Retrospective Study (KROG 19-02)

 Yeon Joo Kim  ;  Yeon-Joo Kim  ;  Yong Bae Kim  ;  Ik Jae Lee  ;  Jeanny Kwon  ;  Kyubo Kim  ;  Jihye Cha  ;  Myungsoo Kim  ;  In Young Jo  ;  Jung Hoon Kim  ;  Jaehyeon Park  ;  Jin Hee Kim  ;  Juree Kim  ;  Kyung Hwan Shin  ;  Su Ssan Kim 
 CANCER RESEARCH AND TREATMENT, Vol.54(2) : 478-487, 2022-04 
Journal Title
Issue Date
Humans ; Prognosis ; Progression-Free Survival ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Triple Negative Breast Neoplasms* / radiotherapy ; Triple Negative Breast Neoplasms* / surgery
Breast surgery ; Postoperative radiotherapy ; Stage IV breast cancer ; Survival
Purpose: This study aimed to investigate the impact of postoperative radiotherapy (PORT) in de novo metastatic breast cancer (dnMBC) patients undergoing planned primary tumor resection (PTR) and to identify the subgroup of patients who would most benefit from PORT.

Materials and methods: This study enrolled 426 patients with dnMBC administered PTR alone or with PORT. The primary and secondary outcomes were overall and progression-free survival (OS and PFS), respectively.

Results: The median follow-up time was 53.7 months (range, 3.1 to 194.4). The 5-year OS and PFS rates were 73.2% and 32.0%, respectively. For OS, clinical T3/4 category, triple-negative breast cancer (TNBC), postoperative chemotherapy alone were significantly poor prognostic factors, and administration of PORT failed to show its significance. Regarding PFS, PORT was a favorable prognostic factor (hazard ratio, 0.64; 95% confidence interval, 0.50 to 0.82; p < 0.001), in addition to T1/2 category, ≤ 5 metastases, and non-TNBC. According to the multivariate analyses of OS in the PORT group, we divided the patients into three groups (group 1, T1/2 and non-TNBC [n=193]; group 2, T3/4 and non-TNBC [n=171]; and group 3, TNBC [n=49]), and evaluated the effect of PORT. Although PORT had no significance for OS in all subgroups, it was a significant factor for good prognosis regarding PFS in groups 1 and 2, not in group 3.

Conclusion: PORT was associated with a significantly better PFS in patients with dnMBC who underwent PTR. Patients with clinical T1/2 category and non-TNBC benefited most from PORT, while those with TNBC showed little benefit.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
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