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17.05.2019 | Breast Oncology

Role of Postmastectomy Radiotherapy After Neoadjuvant Chemotherapy in Breast Cancer Patients: A Study from the Japanese Breast Cancer Registry

Zeitschrift:
Annals of Surgical Oncology
Autoren:
MD, PHD Minoru Miyashita, MD, PHD Naoki Niikura, MD, PHD Hiraku Kumamaru, MD, PHD Hiroaki Miyata, MD, PHD Takayuki Iwamoto, MD, PHD Masaaki Kawai, MD, PHD Keisei Anan, MD, PHD Naoki Hayashi, MD, PHD Kenjiro Aogi, MD, PHD Takanori Ishida, MD, PHD Hideji Masuoka, MD, PHD Kotaro Iijima, MD, PHD Shinobu Masuda, MD, PHD Koichiro Tsugawa, MD, PHD Takayuki Kinoshita, MD, PHD Hitoshi Tsuda, MD, PHD Seigo Nakamura, MD, PHD Yutaka Tokuda
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1245/​s10434-019-07453-1) contains supplementary material, which is available to authorized users.

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Abstract

Background

The role of postmastectomy radiotherapy (PMRT) in breast cancer patients receiving neoadjuvant chemotherapy (NAC) is controversial. We aimed to evaluate the effectiveness of radiotherapy in patients treated with NAC and mastectomy in the Japanese Breast Cancer Registry.

Methods

We enrolled patients who received NAC and mastectomy for cT1–4 cN0–2 M0 breast cancer. We evaluated the association between radiotherapy and outcomes, locoregional recurrence (LRR), distant disease-free survival (DDFS), and overall survival (OS) based on ypN status by multivariable analysis.

Results

Of the 145,530 patients, we identified 3226 who met the inclusion criteria. Among ypN1 patients, no differences were found in LRR, DDFS, or OS between groups with and without radiotherapy (p = 0.72, p = 0.29, and p = 0.36, respectively). Radiotherapy was associated with improved LRR-free survival (p < 0.001), DDFS (p = 0.01), and OS (p < 0.001) in patients with ypN2–3. Multivariable analysis demonstrated that use of radiotherapy was independently associated with improved LRR [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.45–0.82, p = 0.001] and OS [HR 0.69, 95% CI 0.53–0.89, p = 0.004) for ypN2–3 patients only. The association between radiotherapy and OS was not statistically significant among ypN0 (p = 0.22) and ypN1 patients (p = 0.51).

Conclusions

The results from this nationwide database study did not show significant associations between PMRT and improved survival among ypN0 and ypN1 patients. Radiotherapy may be beneficial only for ypN2–3 breast cancer patients who receive NAC and mastectomy in the modern era.

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Zusatzmaterial
Supplementary material 1 (DOCX 228 kb)
10434_2019_7453_MOESM1_ESM.docx
Literatur
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