In the analysis of all patients, locoregional recurrence, tumour size, whether the cancer had spread to the lymph nodes, young age, oestrogen receptor status and treatment with chemotherapy were all independent prognostic factors with a significant impact on long-term outcome, with locoregional recurrence being the strongest factor.
In the second analysis looking at patients who were disease-free after at least five years, locoregional recurrence was the strongest independent prognostic factor for overall survival and metastases-free survival. In the third analysis looking at patients who were disease-free after at least ten year, locoregional recurrence was the only independent prognostic factor.
Dr Mieog said: "These findings suggest that even after a long, event-free interval, locoregional recurrence seems to be associated with distant disease rather than a cause of subsequent distant disease."
Dr Jos A. van der Hage, MD PhD, a surgical oncologist at The Netherlands Cancer Institute (Amsterdam, The Netherlands) who collaborated with Dr Mieog but was unable to attend EBCC7, explained: "Locoregional recurrence is a well-known risk factor for subsequent distant disease and death. The nature of this relationship is not clear. However, most recurrences are not causes of subsequent disease spread but rather a symptom of disease progression, associated with a high likelihood of simultaneous metastases.
"On the other hand, approximately 25% of all local recurrences are believed to be able to induce further disease progression themselves. This rationale is based upon the fact that radiotherapy trials demonstrate a decrease in local recurrence rates as well as improved long-term outcome in patients receiving adjuvant radiotherapy after breast surgery.
"The fact that locoregional recurrence i
|Contact: Mary Rice|
ECCO-the European CanCer Organisation