title: Prognostic factors for survival after breast conserving therapy for stage I and II breast cancer. The role of local recurrence.
abstract: Risk factors for local recurrence (LR) in a univariate analysis had a significant correlation with survival. Local and distant failure could not be regarded as independent events. We undertook a multivariate survival analysis to study the relation between LR and survival. In a retrospective study of 1026 patients treated with tumorectomy, axillary dissection and radiotherapy, factors associated with disease-specific survival (DSS) were analysed. Actuarial estimates for DSS are 91% at 5 years and 86% at 10 years. The multivariate analysis revealed five factors: clinical stage, number of affected axillary nodes, histological grade, degree of tubule formation and left-sided primary tumour. Controlling for these factors, LR appeared to be significantly correlated with DSS. The hazard rate of DSS was estimated to increase by a factor 8.8 (95% confidence interval 4.6-16.8) upon occurrence of a LR. Local recurrence per se, apart from the identified prognostic factors, is a risk factor for DSS. The exact mechanism by which LR has an influence on survival cannot be clarified from these data.
authors.affiliation: Dept. of Surgery, Nederlands Kanker Instituut/Antoni van Leeuwenhoek Huis, Amsterdam, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Kemperman
authors.forename: J
authors.initials: J
authors.lastname: Borger
authors.forename: A
authors.initials: A
authors.lastname: Hart
authors.forename: H
authors.initials: H
authors.lastname: Peterse
authors.forename: H
authors.initials: H
authors.lastname: Bartelink
authors.forename: J
authors.initials: J
authors.lastname: van Dongen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate