Patterns of failure after definitive treatment for T4a larynx cancer in the Veterans Affairs Health System.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18006-e18006
Author(s):  
Rohith S. Voora ◽  
Bharat Panuganti ◽  
Mitchell Flagg ◽  
Abhishek Kumar ◽  
Nikhil V. Kotha ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Disease Recurrence ◽  
Distant Recurrence ◽  
Larynx Cancer ◽  
Definitive Treatment ◽  
Lower Probability ◽  
Cancer Specific Survival ◽  
Curative Intent

e18006 Background: Both chemoradiotherapy (CRT) and total laryngectomy (TL) with adjuvant therapy are curative-intent treatment options for patients with T4a larynx cancer. Disease recurrence is a known negative prognosicator, but differences in recurrence patterns and the subsequent survival associations are not well characterized. To address this knowledge gap, we present long-term recurrence and survival outcomes from a novel longitudinal data source. Methods: Retrospective study of non-metastatic T4a larynx cancer patients diagnosed between 2000-2017 who underwent curative-intent treatment (TL with adjuvant therapy or primary CRT) from the VA Informatics and Computing Infrastructure database. Adjuvant therapy consisted of either postoperative radiotherapy (RT) or CRT. Fine-Gray and Cox models were used to evaluate primary outcomes – time to locoregional recurrence and distant recurrence. Secondary outcomes included overall survival (OS), cancer-specific survival (CSS), non-cancer specific survival (NCSS), and disease-free survival (DFS). These multivariable models accounted for age, race, alcohol history, smoking status, education and income, Charlson-Deyo score, N-classification, and tumor subsite. Results: The study included 1,114 patients with a median follow-up time of 63.3 months among those alive at last follow up. In the TL group, adjuvant RT was used in 69% and adjuvant CRT was used in 31%. Median time to first recurrence was 24.4 months with overall incidence of 28.5% locoregional and 9.5% distant recurrence. Primary CRT patients had higher rates of locoregional (37.2 vs. 22.9%) and distant recurrence (13.3 vs. 7.0%) (p < 0.0001). Median OS was 27.3 months for CRT (95% CI: 23.6-32.4 months) and 47.5 months (95% CI: 39.6-52.1 months) for TL. Median DFS was 14.1 months for CRT (95% CI:12.5-17.2 months) and 37.9 months (95% CI 31.2-47.5 months) for TL. On multivariable analysis compared to CRT, TL was associated with longer time to locoregional (HR 0.50, 95% CI:0.40-0.61) and distant recurrence (HR 0.50, 95% CI:0.34-0.73). Having N+ disease increased risk of distant recurrence (HR 2.20, 95% CI:1.42-3.41). TL was associated with improved OS (HR 0.78, 95% CI:0.67 – 0.91), CSS (HR 0.73, 95% CI:0.59 – 0.89), and DFS (HR 0.58, 95% CI 0.49-0.69) compared to CRT; NCSS was equivalent between groups (HR 1.09, 95% CI:0.88-1.35). Of the CRT patients with locoregional failures, 67/163 (41.1%) were salvaged with surgery. Conclusions: In this cohort of T4a larynx cancer patients, surgical management demonstrated favorable recurrence and survival results. TL with adjuvant therapy was associated with significantly lower incidence of both locoregional and distant recurrence and increased OS, CSS and DFS compared to CRT. Lower probability of disease recurrence, in addition to a survival advantage, should be considered as an important advantage to up-front surgery.

scholarly journals Long-Term Outcomes of Colon Cancer Patients Undergoing Standardized Technique Operation With Curative Intent

2015 ◽  
Vol 100 (11-12) ◽  
pp. 1382-1395
Author(s):  
Erhan Akgun ◽  
Cemil Caliskan ◽  
Tayfun Yoldas ◽  
Can Karaca ◽  
Bulent Karabulut ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Disease Recurrence ◽  
R0 Resection ◽  
Cancer Specific Survival ◽  
Curative Intent ◽  
Lymph Node Count

There is no defined standard surgical technique accepted worldwide for colon cancer, especially on the extent of resection and lymphadenectomy, resulting in technical variations among surgeons. Nearly all analyses employ more than one surgeon, thus giving heterogeneous results on surgical treatment. This study aims to evaluate long-term follow-up results of colon cancer patients who were operated on by a single senior colorectal surgeon using a standardized technique with curative intent, and to compare these results with the literature. A total of 269 consecutive patients who were operated on with standardized technique between January 2003 and June 2013 were enrolled in this study. Standardized technique means separation of the mesocolic fascia from the parietal plane with sharp dissection and ligation of the supplying vessels closely to their roots. Patients were assessed in terms of postoperative morbidity, mortality, disease recurrence, and survival. Operations were carried out with a 99.3% R0 resection rate and mean lymph node count of 17.7 nodes per patient. Surviving patients were followed up for a mean period of 57.8 months, and a total of 19.7% disease recurrence was recorded. Mean survival was 113.9 months. The 5- and 10-year survival rates were 78% and 75.8% for disease-free survival, 82.6% and 72.9% for overall survival, and 87.5% and 82.9% for cancer-specific survival, respectively. R1 resection and pathologic characteristics of the tumor were found to be the most important prognostic factors according to univariate and Cox regression analyses. Standardization of surgical therapy and a dedicated team are thought to make significant contributions to the improvement of prognosis.

Minimal effect of initial TNM stage on follow-up intensity for rectal cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14508-14508
Author(s):  
K. Ode ◽  
K. S. Virgo ◽  
W. E. Longo ◽  
R. A. Audisio ◽  
F. E. Johnson
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Radical Surgery ◽  
Tnm Stage ◽  
Stage I ◽  
Stage Iii ◽  
Office Visits ◽  
Curative Intent

14508 Background: For rectal cancer patients, the risk of recurrence after curative-intent treatment is directly related to initial tumor stage. It is often assumed that more intensive follow-up is worthwhile in patients with high TNM stage lesions, while less intensive follow- up is sufficient for those with low TNM stage cancers. We carried out a survey of members of the American Society of Colon and Rectal Surgeons (ASCRS) to determine the surveillance strategies they use after primary curative-intent treatment for their own patients. This report describes the variation in surveillance intensity ascribable to initial TNM stage. Methods: We created a series of 4 vignettes succinctly describing generally healthy patients with rectal carcinoma (stage I treated with local excision, stage I treated with radical surgery, stage II treated with radical surgery, and stage III treated with radical surgery ± adjuvant therapy). We mailed a questionnaire based on the vignettes to all 1,795 members of ASCRS. Evaluable replies were entered into a computer database. The effect of TNM stage on follow-up intensity was analyzed using repeated-measures ANOVA. Results: There were 566 responses (32%), among which 347 (61%) were evaluable. The most frequent surveillance modality was office visit. In post-operative year 1 for patients with stage I lesions treated with local therapy, 3.8 ± 1.4 office visits (mean ± SD) were recommended, decreasing to 1.5 ± 0.8 in year 5. For patients with stage III lesions treated with radical surgery ± adjuvant therapy, 4.0 ± 2.8 office visits were recommended in year 1, decreasing to 1.7 ± 1.2 in year 5. Similar results were generated for all commonly used modalities on the questionnaire (3 blood tests, 2 endoscopic procedures, 8 imaging studies). Conclusions: The intensity of post-operative surveillance following curative-intent treatment for rectal cancer varies minimally by TNM stage. Because of this, a randomized trial of alternate follow-up strategies may be feasible without stratification according to stage. We will present the schema of such a trial at the meeting. No significant financial relationships to disclose.

scholarly journals 18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382110246
Author(s):  
Seokmo Lee ◽  
Yunseon Choi ◽  
Geumju Park ◽  
Sunmi Jo ◽  
Sun Seong Lee ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Concurrent Chemoradiotherapy ◽  
Curative Intent ◽  
Squamous Cell Esophageal Cancer ◽  
Pet Ct ◽  
Significant Difference ◽  
Fdg Pet Ct

Background and Aims: This study evaluated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) performed before and after concurrent chemoradiotherapy (CCRT) in esophageal cancer. Methods: We analyzed the prognosis of 50 non-metastatic squamous cell esophageal cancer (T1-4N0-2) patients who underwent CCRT with curative intent at Inje University Busan Paik Hospital and Haeundae Paik Hospital from 2009 to 2019. Median total radiation dose was 54 Gy (range 34-66 Gy). Our aim was to investigate the relationship between PET/CT values and prognosis. The primary end point was progression-free survival (PFS). Results: The median follow-up period was 9.9 months (range 1.7-85.7). Median baseline maximum standard uptake value (SUVmax) was 14.2 (range 3.2-27.7). After treatment, 29 patients (58%) showed disease progression. The 3-year PFS and overall survival (OS) were 24.2% and 54.5%, respectively. PFS was significantly lower ( P = 0.015) when SUVmax of initial PET/CT exceeded 10 (n = 22). However, OS did not reach a significant difference based on maximum SUV ( P = 0.282). Small metabolic tumor volume (≤14.1) was related with good PFS ( P = 0.002) and OS ( P = 0.001). Small total lesion of glycolysis (≤107.3) also had a significant good prognostic effect on PFS ( P = 0.009) and OS ( P = 0.025). In a subgroup analysis of 18 patients with follow-up PET/CT, the patients with SUV max ≤3.5 in follow-up PET/CT showed longer PFS ( P = 0.028) than those with a maximum SUV >3.5. Conclusion: Maximum SUV of PET/CT is useful in predicting prognosis of esophageal cancer patients treated with CCRT. Efforts to find more effective treatments for patients at high risk of progression are still warranted.

Áp dụng hóa bảng phân loại của ST GALLEN 2013 trong phân nhóm phân tử ung thư vú biểu mô tuyến vú

2020 ◽  
Author(s):  
Chu Nguyen Van
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Molecular Classification ◽  
Breast Cancer Patients ◽  
Luminal A ◽  
Prognostic Information ◽  
Patient Groups

Molecular classification of breast cancer is target to category patient groups who need to treat by the appropriate adjuvant therapy and provide more exact prognostic information. Purpose: Determining the proportion of molecular types and commenting on some association with clinicpathological characteristics of breast cancer. Methods: 521 operated breast cancer patients were stained by immunohistochemistry with markes such as: ER, PR, HER2, and Ki67 for classifying into 5 molecular categories and follow up assessment. Results: Type LUMBH- accounted for the highest proportion of 26.5%, followed by luminal A (22.5%). Typically, LUMA was the highest rate in good NPI (35.0%), whereas in poor NPI group, HER2 type was the highest rate (36.4%) (p<0.001). The LUMBH - group has the OS rate during the 5-year follow-up of 94.6% and LUMA is 93.5%; In contrast, the HER2 group showed the lowest OS ratio (72.6%) (p<0.05). Conclusion: Molecular classification of breast cancer according to St Gallen 2013 classification can provide the important information for treatment and prognosis.

Impact of dose-capping chemotherapy in concurrent chemoradiotherapy in rectal cancer patients

2020 ◽  
pp. 107815522096219
Author(s):  
Ran Yang ◽  
Moftah Younis ◽  
Kurian Joseph ◽  
Sunita Ghosh ◽  
Tirath Nijjar ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Binary Logistic Regression ◽  
Disease Recurrence ◽  
Kaplan Meier ◽  
Significant Toxicity ◽  
Increased Risk ◽  
Risk Of Disease ◽  
Chemotherapy Dose

Introduction The study evaluated the effect of chemotherapy dose-capping on disease recurrence, toxicity and survival of rectal cancer patients treated with chemoradiotherapy (CRT). Methods 601 consecutive rectal cancer patients treated with concurrent CRT were retrospectively analysed. Dose-capped patients were defined as having a body surface area (BSA) ≥2.0 m2 and who received <95% full weight-based chemotherapy dose. Binary logistic regression was used to study the factors associated with the outcome variables (capped vs. uncapped). Kaplan-Meier estimation evaluated significant predictors of survival. Results The median follow-up time was 7.54 years. The rate of disease recurrence was significantly higher in dose-capped patients (35%) compared to those without dose-capping (24%, P = 0.016). The adjusted odds ratio for dose-capped patients experiencing recurrence was 1.64 compared to uncapped patients (95% CI, 1.10–2.43). Overall, dose-capped patients were less likely to experience significant toxicity requiring dose reduction and/or treatment break when compared to uncapped patients (15% and 28% respectively, P = 0.008).There was significant differences in PFS between capped and uncapped group (77% vs. 85%; P = 0.017). The 5-year OS in the capped group was 75.0%, and 80% in the uncapped group ( P = 0.149). Conclusions Rectal cancer patients treated with dose-capped CRT were at increased risk of disease recurrence. Patients dosed by actual BSA did experience excessive toxicity compared to dose-capped group. We recommend that chemotherapy dose-capping based on BSA should not be practiced in rectal cancer patients undergoing CRT.

Validation of a genomic classifier (ColoPrint) for predicting outcome in the T3-MSS subgroup of stage II colon cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3510-3510 ◽  
Author(s):  
Ramon Salazar ◽  
Josep Tabernero ◽  
Victor Moreno ◽  
Ulrich Nitsche ◽  
Thomas Bachleitner-Hofmann ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Lower Risk ◽  
Low Risk ◽  
Stage Ii ◽  
Disease Relapse ◽  
Risk Of Disease

3510 Background: Adjuvant therapy for stage II patients is recommended for patients with high risk features, especially with T4 tumors. Adjuvant therapy is not indicated for patients with MSI-H status who are considered of being at low risk of disease relapse. However, this leaves the majority of patients with an undetermined risk. ColoPrint is an 18-gene expression classifier that identifies early-stage colon cancer patients at higher risk of disease relapse. Methods: ColoPrint was developed using whole genome expression data and was validated in public datasets (n=322) and independent patient cohorts from 5 European hospitals. Tissue specimen, clinical parameters, MSI-status and follow-up data (median follow-up 70 months) for patients were available and the ColoPrint index was determined using validated diagnostic arrays. Uni-and multivariate analysis was performed on the pooled stage II patient set (n=320) and the subset of patients who were T3/ MSS (n=227). Results: In the analysis of all stage II patients, ColoPrint classified two-third of stage II patients as being at lower risk. The 3-year Relapse-Free-Survial (RFS) RFS was 91% for Low Risk and 74% for patients at higher risk with a HR of 2.9 (p=0.001). Clinicopathological parameters from the ASCO recommendations (T4, perforation, <12 LN assessed, and/ or high grade) or NCCN guidelines (ASCO factors plus angio-lymphatic invasion) did not predict a differential outcome for high risk patients (p< 0.20). In the subgroup of patients with T3 and MSS phenotype, ColoPrint classified 61% of patients at lower risk with a 3-year RFS of 91% (86-96%) and 39% of patients at higher risk with a 3-year RFS of 73% (63-83%) (p=0.002). No clinical parameter was significantly prognostic in this subgroup. Conclusions: ColoPrint combined with established clinicopathological factors and MSI, significantly improves prognostic accuracy, thereby facilitating the identification of patients at higher risk who might be considered for additional treatment.

Cost of surveillance imaging in head and neck cancer patients treated with definitive radiotherapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6610-6610
Author(s):  
Sweet Ping Ng ◽  
Mona K Jomaa ◽  
Courtney Pollard ◽  
Zeina Ayoub ◽  
Abdallah Mohamed ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Clinical Finding ◽  
Disease Recurrence ◽  
Asymptomatic Patients ◽  
Surveillance Imaging ◽  
The Cost

6610 Background: The goal of surveillance is to detect potentially salvageable recurrence, allowing early salvage treatment and thereby improving clinical outcomes. Currently, there is limited data on the optimal frequency of imaging for head and neck cancer patients treated with definitive radiotherapy. This study aims to evaluate the cost-effectiveness of surveillance imaging in this group of patients. Methods: Eligible patients included those with a demonstrable disease free interval (≥ 1 follow up scan without evidence of disease and a subsequent visit/scan) treated between 2000-2010. Age, tumor site and stage, induction chemotherapy use, dose/ fractionation, mode of detection of recurrence, salvage therapy, number and modality of scans were recorded. Deaths from disease recurrence or from other causes were also recorded. Imaging costs were calculated based on the 2016 Medicare fee schedule. Results: 1508 patients were included. Mean age was 55.8 years (range: 17-87). Median overall survival was 99 months (range: 6-199). Mean imaging follow up period was 70 months. 190 (12.6%) patients had disease recurrence – 107 locoregional (LR) and 83 distant. 119 (62.6%) of the relapsed group were symptomatic and/or had an adverse clinical finding associated with recurrence. 80.4% of LR relapses presented with a clinical finding, while 60.2% of distant relapses were detected via imaging alone in asymptomatic patients. There was no difference between the successful salvage rates and overall survival between those with relapses detected clinically or via imaging alone. 70% of relapses occurred within the first 2 years post-treatment. In those who relapsed after 2 years, the median time to relapse was 51 months (2 LR and 11 distant relapses). After 2 years, the average cost for detecting a salvageable recurrence for image-detected group was $741 447.41, and the cost for preventing 1 recurrence-related death for image-detected disease was $889 736.89. The number of scans required to detect a salvageable recurrence in an asymptomatic patient after 2 years was 3512. Conclusions: Surveillance imaging in asymptomatic patients without clinically suspicious findings beyond 2 years requires judicious consideration.

The role of routine surveillance imaging in detecting oral cavity cancer recurrence in asymptomatic patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18561-e18561
Author(s):  
Jeffrey Chi ◽  
Su Yun Chung ◽  
Carlos Alberto Lopez ◽  
Douglas K. Frank ◽  
Lucio Pereira ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Residual Disease ◽  
Cancer Recurrence ◽  
Retrospective Chart Review ◽  
Disease Recurrence ◽  
Post Treatment ◽  
Definitive Treatment ◽  
Curative Intent ◽  
Asymptomatic Patients ◽  
Surveillance Imaging

e18561 Background: The optimal surveillance approach for patients who were definitively treated for oral squamous cell carcinoma (OSCC) is unclear, but it includes physical exams (PE) and surveillance imaging (SI) studies at intervals that vary amongst institutions. At our institution, patients are seen in office and underwent PE monthly for the first 3-6 months then every 3 months thereafter. SI is performed every 3 months during the first 2 years, every 6 months till year 4, and yearly thereafter. Concerning symptoms or findings resulting from PE or SI may trigger further tests including biopsies as deemed necessary by treating team. In this study, we investigated value of SI in detecting recurrence of OSCC. Methods: Retrospective chart review was performed for the patients who were diagnosed with OSCC from 2014 to 2017 at our institution. Eligible patients included those who underwent definitive treatment (surgery, chemotherapy, radiation) of OSCC with curative intent. Patients without evidence of disease on post treatment imaging were included. Results: Two hundred OSCC patients were treated definitively. 138 (69%) patients had local disease and 62 (31%) patients had regional disease. 183 patients (%) had no clinical evidence of disease on post treatment baseline imaging. Patients who had residual disease on post-to scab were excluded from further analysis. The median follow-up was 29 months. 2-year overall survival was 87.4%. 82 patients underwent biopsy for suspicious findings and 44 patients had confirmed recurrence. 37 (84.1%) of the recurrences occurred in the first two years. 28 (63.6%) of recurrences were local, 13 (29.5%) were regional and 3 (6.8%) were metastases. 31 (70.6%) of patients with disease recurrence presented with clinical symptoms or had suspicious findings on PE. 13 (29.4%) of the recurrences were detected by SI alone (PPV=54.2 %) in asymptomatic patients most of which (92.3%) occurred within first 2 years. Conclusions: Majority of OSCC recurrence were detected due to clinical symptoms or positive findings on PE. However, 29.4% of recurrences were detected by SI alone in asymptomatic patients suggesting a role for SI for the first 2 years post-treatment of OSCC. Larger prospective studies are needed to determine the optimal frequency of SI.

scholarly journals Endobronchial Brachytherapy as Definitive Treatment for Endobronchial Metastasis After Surgery of Non-Small-Cell Lung Cancer

2021 ◽  
Author(s):  
Atsushi Ito ◽  
Daisuke Yamaguchi ◽  
Shinji Kaneda ◽  
Koji Kawaguchi ◽  
Akira Shimamoto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
External Beam Radiation ◽  
Definitive Treatment ◽  
Small Cell Lung ◽  
Curative Intent ◽  
Endobronchial Metastasis

Abstract Background Endobronchial metastasis is a very rare type of recurrence after lung cancer surgery. Surgical intervention may be difficult to perform due to the postoperative reduction in the activities of daily living (ADL) and the invasiveness associated with redo surgery. In such cases, endobronchial brachytherapy (EBBT) plays an important role not only as palliative treatment, but also as definitive treatment with curative intent. Case presentation: Three men (64, 69, and 74 years old) underwent combination therapy of external beam radiation therapy (EBRT) and EBBT for endobronchial metastasis after lobectomy of Stage Ⅰ-Ⅱ non-small-cell lung cancer (NSCLC): 2 cases of squamous cell carcinoma and 1 of adenocarcinoma. We used a special source-centralizing applicator for EBBT to avoid eccentric distribution of the radiation dose. Follow-up was considered to start from the end of brachytherapy. None of our patients experienced severe adverse events, and none needed extensive outpatient treatment. Local control was achieved in all cases by a bronchoscopic evaluation. All patients were alive after 31, 38, and 92 months of follow up, respectively. In the adenocarcinoma patient, two metastases to the lung were discovered three years after EBBT, and the patient underwent partial wedge resection. Conclusions EBBT may be a promising treatment with curative intent for endobronchial metastasis after surgery of NSCLC.

Recurrence rates and long-term survival in women diagnosed with breast cancer at age 40 and younger.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 70-70 ◽  
Author(s):  
J. M. Buckley ◽  
S. Coopey ◽  
S. Samphao ◽  
M. C. Specht ◽  
K. S. Hughes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Breast Conservation ◽  
Disease Recurrence ◽  
Distant Recurrence ◽  
Recurrence Rates ◽  
Term Survival ◽  
Long Term Survival

70 Background: Young age at diagnosis of breast cancer has been reported to be an independent risk factor for disease recurrence. However, there is little data on long term survival of young patients. We present long term follow up of a large cohort of women diagnosed with breast cancer at age 40 and younger. We determined rates of loco-regional recurrence (LRR), distant recurrence, and overall survival and adjusted for the patient and tumor characteristics which potentially predict outcomes. Methods: Following Institutional Review Board approval, data from the medical records of 628 women diagnosed with breast cancer at age 40 or younger between 1996 and 2008 were collected. Survival curves were estimated using the Kaplan Meier method. Results: Median age was 37 years (range: 21-40) and median follow-up was 72 months (range: 5-177). The rates of LRR as a first site of recurrence were 5.56% at 5 years and 12.11% at 10 years. In the entire population, with median follow-up of 72 months, there was no difference in the rates of loco-regional failure between patients who underwent breast conserving therapy (7.34%) compared to mastectomy (7.40%) (p=0.980). The rates of distant recurrence as a first event were 10.65% at 5 years and 14.58% at 10 years. Overall survival was 93.1% at 5 years and 87.26% at 10 years. 79.1% of patients received systemic therapy. For patients who developed disease recurrence, either LRR or distant, median time to first recurrence was 35 months (range: 3-167). Conclusions: Women aged 40 and younger at diagnosis of breast cancer have a good prognosis, with low overall recurrence rates at 5 and 10 years. Local recurrence in our cohort is lower than in prior studies, suggesting advances in therapy have made breast conservation a safe option in young breast cancer patients.

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