Vinh-Hung, Vincent
[UCL]
Burzykowski, Tomasz
[Limburgs Universitair Centrum]
Van de Steene, Jan
[Oncologisch Centrum]
Storme, Guy
[Oncologisch Centrum]
Soete, Guy
[Oncologisch Centrum]
Background and purpose: Overviews of randomized trials have shown a small survival advantage with post-surgery radiation in early breast cancer. The present study attempts to extend this observation through a systematic analysis of population data.
Materials and methods: This retrospective cohort study used the Surveillance, Epidemiology, and End Results (SEER) data on 83,776 women with breast cancer diagnosed between 1988 and 1997, stage T1-T2, node negative or node positive. The analysis was performed using the proportional hazard models.
Results: Radiation was associated with a reduced mortality after breast-conserving surgery in node negative patients (hazard ratio 0.757; 95% confidence interval 0.709-0.809; using total mastectomy without radiation as reference) and in node positive patients (hazard ratio 0.777; 0.717-0.842), and after total mastectomy in node positive patients (hazard ratio 0.885; 0.815-0.961). Radiation was associated with an increased hazard ratio of 1.271 (1.080-1.496) after total mastectomy in node negative patients. Without radiation, breast-conserving surgery in node negative patients was associated with an increased hazard ratio (1.167; 1.036-1.314); a similar increase was not observed in node positive patients (hazard ratio 1.011; 0.884-1.155). In all cases, the best survival rates were found with combined breast-con serving surgery and radiation.
Conclusion: The available data indicate that post-surgery radiation provides a survival advantage irrespective of the type of surgery in node positive patients. Likewise, survival advantage was observed with post-surgery radiation and breast-conserving procedure in node negative patients. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
Bibliographic reference |
Vinh-Hung, Vincent ; Burzykowski, Tomasz ; Van de Steene, Jan ; Storme, Guy ; Soete, Guy. Post-surgery radiation in early breast cancer: survival analysis of registry data. In: Radiotherapy & Oncology, Vol. 64, no. 3, p. 281-290 (2002) |
Permanent URL |
http://hdl.handle.net/2078.1/41536 |