11 research outputs found
Clinical implication of internal mammary lymph node biopsy during immediate breast reconstruction using autologous tissue free flaps in breast cancer surgery.
Oncological safety of oncoplastic breast conserving surgery-compare with conventional breast conserving surgery and total mastectomy.
Clinical significance of axillary lymph node count in axillary dissection following neoadjuvant chemotherapy for breast cancer.
The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities
<div><p>Purpose</p><p>Studies have suggested a potential role of patient’s co-morbidity in determining the survival outcomes of breast cancer. In this study, we examined the long-term oncologic outcomes in breast cancer patients who underwent curative surgery according to their pre-existing comorbid conditions and analyzed the association between the co-morbidity and the use of adjuvant therapies.</p><p>Methods</p><p>The medical records of 2,501 patients who underwent surgery for primary breast cancer from June 2006 to June 2010 were reviewed retrospectively. The patients were classified into three groups according to preoperative ASA status determined by the anesthesiologists. Clinico-pathologic characteristics and survival outcomes of the patients were compared among the different co-morbidity groups.</p><p>Results</p><p>There were 1,792 (71.6%), 665 (26.6%), and 44 (1.8%) patients in ASA I, II, and III, respectively. Total 95 (3.8%) deaths and 269 (10.8%) recurrences (loco-regional and distant) occurred during the median follow-up period of 71 months. Patients with high comorbidity showed significantly higher rate of deaths (51 (2.8%), 38 (5.7%) and 6 (13.6%) deaths in ASA I, II and III group, respectively, p<0.001). The ASA 3 patients also showed significantly higher rate of breast cancer recurrence when compared to other groups (180 (10.0%), 80 (12.0%) and 9 (20.5%) in ASA I, II, and III, respectively, p = 0.041). Significantly fewer patients in the high co-morbidity group received adjuvant therapies (77 (4.3%), 44 (6.6%) and 8 (18.2%) in ASA I, II, and III, respectively, p<0.001). The increased recurrence of breast cancer in the high morbidity group was mostly seen in patients who did not receive adjuvant therapies. The incidence of serious adverse effect during the adjuvant therapy did not differ according to the co-morbidity conditions.</p><p>Conclusions</p><p>In this study, high comorbidity was related to increased risk of death and recurrence in breast cancer. The increased risk of recurrence in high co-morbidity group was mostly seen in patients who did not receive adjuvant therapies. Considering the relatively low rates of serious adverse effects in high co-morbidity patients who received adjuvant therapies, active use of adjuvant therapies in selected patients may improve survival outcomes in breast cancer patients with severe co-morbidities.</p></div
Characteristics in each American Society of Anesthesiologists (ASA) group.
<p>Characteristics in each American Society of Anesthesiologists (ASA) group.</p
Disease-free survival, overall-survival, and breast cancer-specific survival according to the ASA status.
<p>Kaplan-Meier survival curves for the disease-free survival (A), overall survival (B), and breast cancer-specific survival (C) are shown (<i>P</i>-value is analyzed with comparing to ASA 1 group).</p
Multivariate and univariate analysis of mortality and recurrence in American Society of Anesthesiologists (ASA) groups.
<p>Multivariate and univariate analysis of mortality and recurrence in American Society of Anesthesiologists (ASA) groups.</p
Characteristics among 2,501 patients underwent surgery for breast cancer, 2006–2010.
<p>Characteristics among 2,501 patients underwent surgery for breast cancer, 2006–2010.</p