© 2004 by Oxford University Press
© 2004 Oxford University Press
ARTICLE |
Breast-Conserving Surgery With or Without Radiotherapy: Pooled-Analysis for Risks of Ipsilateral Breast Tumor Recurrence and Mortality
For The Breast Conserving Surgery Project
Affiliations of authors: Oncology Center, Academic Hospital, Vrije Universiteit Brussel, Jette, Belgium (VVH); Division of Hematology Oncology, The University of New Mexico, Cancer Research and Treatment Center, Albuquerque, NM (CV).
Correspondence to: Vincent Vinh-Hung, MD, Oncology Center, Academic Hospital, Vrije Universiteit Brussel, 101 Laarbeeklaan, B-1090 Jette, Belgium (e-mail: conrvhgv{at}az.vub.ac.be)
Background: The objective of the study was to investigate whether radiotherapy or its omission after breast-conserving surgery has measurable consequences on local tumor growth and patient survival. Methods: We conducted a pooled analysis of published randomized clinical trials that compared radiotherapy versus no radiotherapy after breast-conserving surgery. The outcomes studied were ipsilateral breast tumor recurrence and patient death from any cause. The pooled relative risks (RRs) were estimated with a random-effects model. Heterogeneity was assessed using the Cochran Q test. Results: A search of the literature identified 15 trials with a pooled total of 9422 patients available for analysis. The relative risk of ipsilateral breast tumor recurrence after breast-conserving surgery, comparing patients treated with no radiotherapy or radiotherapy, was 3.00 (95% confidence interval [CI] = 2.65 to 3.40). Mortality data were available for 13 trials with a pooled total of 8206 patients. The relative risk of mortality was 1.086 (95% CI = 1.003 to 1.175), corresponding to an estimated 8.6% (95% CI = 0.3% to 17.5%) relative excess mortality if radiotherapy was omitted. Conclusion: Omission of radiotherapy is associated with a large increase in risk of ipsilateral breast tumor recurrence and with a small increase in the risk of patient mortality.
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Correspondence about this Article
- Re: Breast-Conserving Surgery With or Without Radiotherapy: Pooled-Analysis for Risks of Ipsilateral Breast Tumor Recurrence and Mortality
- Claire Verschraegen and Vincent Vinh-Hung
J Natl Cancer Inst 2004 96: 1111-1112.[Extract] [Full Text] [PDF]
- Re: Breast-Conserving Surgery With or Without Radiotherapy: Pooled-Analysis for Risks of Ipsilateral Breast Tumor Recurrence and Mortality
- Ian Kunkler, Linda Williams, Robin Prescott, and Celia King
J Natl Cancer Inst 2004 96: 1255.[Extract] [Full Text] [PDF]
- RESPONSE: Re: Breast-Conserving Surgery With or Without Radiotherapy: Pooled-Analysis for Risks of Ipsilateral Breast Tumor Recurrence and Mortality
- Vincent Vinh-Hung, Claire Verschraegen, Melanie Royce, Jan Van de Steene, Patricia Tai, Gábor Cserni, Guy Storme, and Georges Vlastos
J Natl Cancer Inst 2004 96: 1255-1257.[Extract] [Full Text] [PDF]
Editorial about this Article
- Postoperative Radiotherapy for Breast Cancer: Growing Evidence for an Impact on Survival
- Katherine A. Vallis and Ian F. Tannock
J Natl Cancer Inst 2004 96: 88-89.[Extract] [Full Text] [PDF]
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