Waiting time for radiation therapy after breast-conserving surgery in early breast cancer: A retrospective analysis of local relapse and distant metastases in 615 patients

Raffaella Caponio, Maria Paola Ciliberti, Giusi Graziano, Rocco Necchia, Giovanni Scognamillo, Antonio Pascali, Sabino Bonaduce, Anna Milella, Gabriele Matichecchia, Cristian Cristofaro, Davide Di Fatta, Pasquale Tamborra, Marco Lioce

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Postoperative radiotherapy after breast-conserving surgery (BCS) is the standard in the management of breast cancer. The optimal timing for starting postoperative radiation therapy has not yet been well defined. In this study, we aimed to evaluate if the time interval between BCS and postoperative radiotherapy is related to the incidence of local and distant relapse in women with early node-negative breast cancer not receiving chemotherapy. Methods: We retrospectively analyzed clinical data concerning 615 women treated from 1984 to 2010, divided into three groups according to the timing of radiotherapy: ≤60, 61-120, and >120 days. To estimate the presence of imbalanced distribution of prognostic and treatment factors among the three groups, the χ2 test or the Fisher exact test were performed. Local relapse-free survival, distant metastasis-free survival (DMFS), and disease-free survival (DFS) were estimated with the Kaplan-Meier method, and multivariate Cox regression was used to test for the independent effect of timing of RT after adjusting for known confounding factors. The median follow-up time was 65.8 months. Results: Differences in distribution of age, type of hormone therapy, and year of diagnosis were statistically significant. At 15-year follow-up, we failed to detect a significant correlation between time interval and the risk of local relapse (p = 0.09) both at the univariate and the multivariate analysis. The DMFS and the DFS univariate analysis showed a decreased outcome when radiotherapy was started early (p = 0.041 and p = 0.046), but this was not confirmed at the multivariate analysis (p = 0.406 and p = 0.102, respectively). Conclusions: Our results show that no correlation exists between the timing of postoperative radiotherapy and the risk of local relapse or distant metastasis development in a particular subgroup of women with node-negative early breast cancer.

Original languageEnglish
Article number32
JournalEuropean Journal of Medical Research
Volume21
Issue number1
DOIs
Publication statusPublished - 2016

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Segmental Mastectomy
Radiotherapy
Breast Neoplasms
Neoplasm Metastasis
Recurrence
Disease-Free Survival
Multivariate Analysis
Age Distribution
Survival Analysis
Hormones
Drug Therapy
Survival
Incidence
Therapeutics

Keywords

  • Distant metastases
  • Early-stage breast cancer
  • Local relapse
  • Radiotherapy
  • Survival
  • Timing

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Waiting time for radiation therapy after breast-conserving surgery in early breast cancer : A retrospective analysis of local relapse and distant metastases in 615 patients. / Caponio, Raffaella; Ciliberti, Maria Paola; Graziano, Giusi; Necchia, Rocco; Scognamillo, Giovanni; Pascali, Antonio; Bonaduce, Sabino; Milella, Anna; Matichecchia, Gabriele; Cristofaro, Cristian; Di Fatta, Davide; Tamborra, Pasquale; Lioce, Marco.

In: European Journal of Medical Research, Vol. 21, No. 1, 32, 2016.

Research output: Contribution to journalArticle

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title = "Waiting time for radiation therapy after breast-conserving surgery in early breast cancer: A retrospective analysis of local relapse and distant metastases in 615 patients",
abstract = "Background: Postoperative radiotherapy after breast-conserving surgery (BCS) is the standard in the management of breast cancer. The optimal timing for starting postoperative radiation therapy has not yet been well defined. In this study, we aimed to evaluate if the time interval between BCS and postoperative radiotherapy is related to the incidence of local and distant relapse in women with early node-negative breast cancer not receiving chemotherapy. Methods: We retrospectively analyzed clinical data concerning 615 women treated from 1984 to 2010, divided into three groups according to the timing of radiotherapy: ≤60, 61-120, and >120 days. To estimate the presence of imbalanced distribution of prognostic and treatment factors among the three groups, the χ2 test or the Fisher exact test were performed. Local relapse-free survival, distant metastasis-free survival (DMFS), and disease-free survival (DFS) were estimated with the Kaplan-Meier method, and multivariate Cox regression was used to test for the independent effect of timing of RT after adjusting for known confounding factors. The median follow-up time was 65.8 months. Results: Differences in distribution of age, type of hormone therapy, and year of diagnosis were statistically significant. At 15-year follow-up, we failed to detect a significant correlation between time interval and the risk of local relapse (p = 0.09) both at the univariate and the multivariate analysis. The DMFS and the DFS univariate analysis showed a decreased outcome when radiotherapy was started early (p = 0.041 and p = 0.046), but this was not confirmed at the multivariate analysis (p = 0.406 and p = 0.102, respectively). Conclusions: Our results show that no correlation exists between the timing of postoperative radiotherapy and the risk of local relapse or distant metastasis development in a particular subgroup of women with node-negative early breast cancer.",
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author = "Raffaella Caponio and Ciliberti, {Maria Paola} and Giusi Graziano and Rocco Necchia and Giovanni Scognamillo and Antonio Pascali and Sabino Bonaduce and Anna Milella and Gabriele Matichecchia and Cristian Cristofaro and {Di Fatta}, Davide and Pasquale Tamborra and Marco Lioce",
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T2 - A retrospective analysis of local relapse and distant metastases in 615 patients

AU - Caponio, Raffaella

AU - Ciliberti, Maria Paola

AU - Graziano, Giusi

AU - Necchia, Rocco

AU - Scognamillo, Giovanni

AU - Pascali, Antonio

AU - Bonaduce, Sabino

AU - Milella, Anna

AU - Matichecchia, Gabriele

AU - Cristofaro, Cristian

AU - Di Fatta, Davide

AU - Tamborra, Pasquale

AU - Lioce, Marco

PY - 2016

Y1 - 2016

N2 - Background: Postoperative radiotherapy after breast-conserving surgery (BCS) is the standard in the management of breast cancer. The optimal timing for starting postoperative radiation therapy has not yet been well defined. In this study, we aimed to evaluate if the time interval between BCS and postoperative radiotherapy is related to the incidence of local and distant relapse in women with early node-negative breast cancer not receiving chemotherapy. Methods: We retrospectively analyzed clinical data concerning 615 women treated from 1984 to 2010, divided into three groups according to the timing of radiotherapy: ≤60, 61-120, and >120 days. To estimate the presence of imbalanced distribution of prognostic and treatment factors among the three groups, the χ2 test or the Fisher exact test were performed. Local relapse-free survival, distant metastasis-free survival (DMFS), and disease-free survival (DFS) were estimated with the Kaplan-Meier method, and multivariate Cox regression was used to test for the independent effect of timing of RT after adjusting for known confounding factors. The median follow-up time was 65.8 months. Results: Differences in distribution of age, type of hormone therapy, and year of diagnosis were statistically significant. At 15-year follow-up, we failed to detect a significant correlation between time interval and the risk of local relapse (p = 0.09) both at the univariate and the multivariate analysis. The DMFS and the DFS univariate analysis showed a decreased outcome when radiotherapy was started early (p = 0.041 and p = 0.046), but this was not confirmed at the multivariate analysis (p = 0.406 and p = 0.102, respectively). Conclusions: Our results show that no correlation exists between the timing of postoperative radiotherapy and the risk of local relapse or distant metastasis development in a particular subgroup of women with node-negative early breast cancer.

AB - Background: Postoperative radiotherapy after breast-conserving surgery (BCS) is the standard in the management of breast cancer. The optimal timing for starting postoperative radiation therapy has not yet been well defined. In this study, we aimed to evaluate if the time interval between BCS and postoperative radiotherapy is related to the incidence of local and distant relapse in women with early node-negative breast cancer not receiving chemotherapy. Methods: We retrospectively analyzed clinical data concerning 615 women treated from 1984 to 2010, divided into three groups according to the timing of radiotherapy: ≤60, 61-120, and >120 days. To estimate the presence of imbalanced distribution of prognostic and treatment factors among the three groups, the χ2 test or the Fisher exact test were performed. Local relapse-free survival, distant metastasis-free survival (DMFS), and disease-free survival (DFS) were estimated with the Kaplan-Meier method, and multivariate Cox regression was used to test for the independent effect of timing of RT after adjusting for known confounding factors. The median follow-up time was 65.8 months. Results: Differences in distribution of age, type of hormone therapy, and year of diagnosis were statistically significant. At 15-year follow-up, we failed to detect a significant correlation between time interval and the risk of local relapse (p = 0.09) both at the univariate and the multivariate analysis. The DMFS and the DFS univariate analysis showed a decreased outcome when radiotherapy was started early (p = 0.041 and p = 0.046), but this was not confirmed at the multivariate analysis (p = 0.406 and p = 0.102, respectively). Conclusions: Our results show that no correlation exists between the timing of postoperative radiotherapy and the risk of local relapse or distant metastasis development in a particular subgroup of women with node-negative early breast cancer.

KW - Distant metastases

KW - Early-stage breast cancer

KW - Local relapse

KW - Radiotherapy

KW - Survival

KW - Timing

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