J Breast Cancer.  2015 Jun;18(2):160-166. 10.4048/jbc.2015.18.2.160.

Risk Factors Associated with Distant Metastasis and Survival Outcomes in Breast Cancer Patients with Locoregional Recurrence

• Park S
• Han W
• Kim J
• Kim MK
• Lee E
• Yoo TK
• Lee HB
• Kang YJ
• Kim YG
• Moon HG
• Noh DY

• KMID: 2374531
• DOI: http://doi.org/10.4048/jbc.2015.18.2.160

Abstract

PURPOSE
To decide the optimal treatment for breast cancer patients with locoregional recurrence (LRR), it is important to determine which group has the highest risk of subsequent distant metastasis (DM). We aimed to investigate the factors associated with DM in patients with LRR.
METHODS
We reviewed the data of 208 patients with LRR as the first event after primary surgery for breast cancer at our institution between 1997 and 2010, to identify significant factors associated with DM. Subsequently, Kaplan-Meier curves and the Cox regression method were used to analyze the correlation between clinical factors and survival.
RESULTS
DM occurred in 33.2% (68/208) of LRR patients. The median DM-free interval was 23 months. Some clinical factors were associated with DM in univariate analysis, including the type of primary surgery (p=0.026), tumor size (p=0.005), nodal status (p=0.011), and administration of initial adjuvant chemotherapy (p=0.001). In addition, regional rather than local recurrence and a disease-free interval (DFI; duration between primary surgery and LRR) < or =30 months were also significant (p<0.001 for both). However, only a shorter DFI reached significance in multiple logistic regression analysis. Cox regression analysis of DM-free survival showed that both a shorter DFI and regional recurrence were significant factors with hazard ratios of 2.1 (95% confidence interval [CI], 1.21-3.65) and 1.85 (95% CI, 1.04-3.28), respectively.
CONCLUSION
DFI was the most important factor associated with subsequent DM in patients with LRR as a first event of failure.

Keyword

Breast neoplasms; Local neoplasm recurrence; Neoplasm metastasis; Prognosis; Risk factors

MeSH Terms

Breast Neoplasms*
Chemotherapy, Adjuvant
Humans
Logistic Models
Neoplasm Metastasis*
Neoplasm Recurrence, Local
Prognosis
Recurrence*
Risk Factors*

Figure

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  Figure 1 Kaplan-Meier analysis of distant metastasis-free survival (DMFS) in patients with locoregional recurrence (LRR). There was a significant difference in DMFS according to stage (A), tumor size (B), nodal status (C), administration of adjuvant chemotherapy (D), type of LRR (E), and disease-free interval (DFI) (F). LN=lymph node.

• 

  Figure 2 Kaplan-Meier analysis of overall survival (OS) in patients with locoregional recurrence (LRR). There was a significant difference in OS according to stage (A), tumor size (B), nodal status (C), administration of adjuvant chemotherapy (D), type of LRR (E), and disease-free interval (DFI) (F). LN=lymph node.

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