Chemoendocrine therapy for patients with recurrence of breast cancer and its outcome

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  • [原著］再発乳癌に対する治療成績とその予後についての検討

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This study was to investigate retrospectively patients with recurrence of breast cancer to clarify relationship between tumor characteristics at the time of initial surgery and outcome by chemoendocrine treatment strategies. We examined 299 patients with primary breast cancer in our institution between 1987 and 1999. Of these, there were 39 patients (13.0% of all) who developed recurrence. The initial sites of recurrence were skin (17.9% of all recurrence), lymphnodes (25.6%), bone (35.9%), lung/pleura (23.1%), and liver (17.9%). The incidence of recurrence was more frequent in patients with scirrhous carcinomas than in patients with papillotubular carcinomas. Factors of t (p< 0.01), n (p< 0.01), ly (p< 0.01) and macroscopic extension (p< 0.01) at the time of initial surgery were significant predictors for recurrence. Patients with bone or local metastasis were treated with chemoendocnne therapy consisting of cyclophosphamide, 5'-DFUR and medroxyprogesterone acetate with luteimzing hormone-releasing hormone agonist for premenopausal women and aromatase inhibitor for postmenopausal women. Patients with lung or liver metastasis were treated with CEF(cyclophosphamide/epirubicin/5-FU) and endocrine therapy. The overall response rate for this chemoendocrine therapy was 38.0% (complete remission, 9.5%, partial remission, 28.6% and the 5-year survival rate was 9.4%. The patients with liver metastasis had poorer prognosis.

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