METHODS: In this retrospective multicentre study, patients who developed CWRs were reviewed. We excluded patients with suspected or concomitant regional/distant metastases, bilateral cancers and patients without CWR surgery. Patients\' demographics, pathological data and subsequent recurrences were collected from a prospective database and were compared between patients with axillary lymph node dissection (ALND) and/or SLNB versus no axillary operation at CWR.
RESULTS: A total of 194 patients with CWRs were eligible. The median age at CWR was 56.0 (IQR 47.0-67.0) years old. At recurrence, 8 (4.1%), 5 (2.6%) and 181 (93.3%) patients had ALND, SLNB and no axillary operation, respectively. Patients with no axillary surgery during CWR were associated with, at primary cancer, a lower incidence of ductal carcinoma in situ as diagnosis (p = 0.007) and older age (p = 0.022). Subsequent ipsilateral axillary (p = 0.768) and second recurrences (p = 0.061) were not statistically different between patients with and without axillary surgery at CWR on median follow-up of 59.5 (IQR 27.3-105) months.
CONCLUSIONS: In patients without evidence of concomitant regional or distant metastasis at CWR diagnosis, omission of axillary restaging surgery was not associated with an increased ipsilateral axillary or second recurrences on long-term follow-up.
方法:在这项回顾性多中心研究中,对发生CWRs的患者进行了回顾.我们排除了怀疑或伴随的区域/远处转移的患者,双侧癌症和没有CWR手术的患者。患者人口统计学,从前瞻性数据库中收集病理数据和随后的复发情况,并在CWR时行腋窝淋巴结清扫术(ALND)和/或SLNB的患者与未行腋窝手术的患者之间进行比较.
结果:总共194名CWR患者符合资格。CWR的中位年龄为56.0(IQR47.0-67.0)岁。在复发时,8(4.1%),5例(2.6%)和181例(93.3%)患者患有ALND,SLNB和无腋窝手术,分别。CWR期间没有腋窝手术的患者与,在原发性癌症中,导管原位癌的诊断发生率较低(p=0.007),年龄较大(p=0.022)。随后的同侧腋窝(p=0.768)和第二次复发(p=0.061)在CWR进行和未进行腋窝手术的患者之间没有统计学差异,中位随访时间为59.5(IQR27.3-105)个月。
结论:在CWR诊断时没有伴发区域或远处转移证据的患者中,省略腋窝重建手术与长期随访中同侧腋窝复发或第二次复发无关。