Impact on Survival of Regular Postoperative Surveillance for Patients with Early Breast Cancer
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Purpose The purpose of this study is to evaluate the role of regular postoperative surveillance toimprove the prognosis of patients with breast cancer after curative surgery. Materials and MethodsWe retrospectively analyzed the medical records of 4,119 patients who received curativesurgery for breast cancer at Samsung Medical Center between January 2000 and September2008. Patients were divided into two groups (group I, regular postoperative surveillance;group II, control group) according to their post-therapy follow-up status for the first 5 yearsafter surgery. ResultsAmong the 3,770 patients selected for inclusion, groups I and II contained 3,300 (87%)and 470 (13%) patients, respectively. The recurrence rates at 5 years for groups I and IIwere 10.6% and 16.4%, respectively (hazard ratio, 0.85; 95% confidence interval [CI], 0.67to 1.09; p=0.197). The 10-year mortality cumulative rates were 8.8% for group I and 25.4%for group II (hazard ratio, 0.28; 95% CI, 0.22 to 0.35; p < 0.001). In multivariate analysisfor recurrence-free survival (RFS), age over 40 years (p < 0.001), histologic grade 1 (p <0.001), and pathologic stage I (p < 0.001) were associated with longer RFS but not with follow-up status. Multivariate analysis for overall survival (OS) revealed that patients in groupI showed significantly improved OS (hazard ratio, 0.29; 95% CI, 0.23 to 0.37; p < 0.001). Additionally, age over 40 years, histologic grade I, and pathologic stage I were independentprognostic factors for OS. ConclusionRegular follow-up for patients with breast cancer after primary surgery resulted in clinicallysignificant improvements in patient OS.
Abstract
Purpose The purpose of this study is to evaluate the role of regular postoperative surveillance toimprove the prognosis of patients with breast cancer after curative surgery. Materials and MethodsWe retrospectively analyzed the medical records of 4,119 patients who received curativesurgery for breast cancer at Samsung Medical Center between January 2000 and September2008. Patients were divided into two groups (group I, regular postoperative surveillance;group II, control group) according to their post-therapy follow-up status for the first 5 yearsafter surgery. ResultsAmong the 3,770 patients selected for inclusion, groups I and II contained 3,300 (87%)and 470 (13%) patients, respectively. The recurrence rates at 5 years for groups I and IIwere 10.6% and 16.4%, respectively (hazard ratio, 0.85; 95% confidence interval [CI], 0.67to 1.09; p=0.197). The 10-year mortality cumulative rates were 8.8% for group I and 25.4%for group II (hazard ratio, 0.28; 95% CI, 0.22 to 0.35; p < 0.001). In multivariate analysisfor recurrence-free survival (RFS), age over 40 years (p < 0.001), histologic grade 1 (p <0.001), and pathologic stage I (p < 0.001) were associated with longer RFS but not with follow-up status. Multivariate analysis for overall survival (OS) revealed that patients in groupI showed significantly improved OS (hazard ratio, 0.29; 95% CI, 0.23 to 0.37; p < 0.001). Additionally, age over 40 years, histologic grade I, and pathologic stage I were independentprognostic factors for OS. ConclusionRegular follow-up for patients with breast cancer after primary surgery resulted in clinicallysignificant improvements in patient OS.
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