Dataset Information

Survival and Prognostic Factors for Breast Cancer Patients with Regional Oligo-Recurrence.

ABSTRACT:

Purpose

This study aimed to evaluate survival outcomes and identify prognostic factors for regional oligo-recurrence in breast cancer patients who received salvage local treatment.

Methods

In the breast cancer registry of our institution, 18,790 patients received curative surgery for stage I-III breast cancer between January 1995 and June 2016. Of those patients, only 87 (0.5%)underwent salvage local treatment for isolated nodal recurrence on the axillary lymph nodes (ALNs) (n = 58), supraclavicular lymph nodes (SCNs) (n = 17), or internal mammary lymph nodes (IMNs) (n = 12).

Results

The median follow-up duration after regional oligo-recurrence was 49 months (range: 6-194 months). For patients with recurrence of ALN, SCN, or IMN, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 40.0%, 32.1%, and 25.0%, respectively (p = 0.3) and 62.7%, 70.0%, and 58.3%, respectively(p = 0.97). In the multivariable analysis for PFS, age at recurrence ? 65 years, disease-free interval < 24 months, non-luminal A subtype, and in-field failure (marginally significant) were found to be risk factors (RFs). However, the location of the tumor was not a significant factor for PFS (p = 0.71). When we stratified patients by the number of RFs, the 5-year PFS rates were 67.5% for patients with ? 1 RF and 7.3% for those with > 1 RF (p < 0.01). For patients with ? 1 RF, the 5-year PFS rates were 73.5% in the ALN group and 51.1% in the SCN/IMN group (p = 0.09). For patients with > 1 RF, the 5-year PFS rates were 7.3% in the ALN group and 7.1% in the SCN/IMN group (p = 1.00).

Conclusion

In breast cancer patients with regional oligo-recurrence, clinical outcomes after salvage treatment were favorable in patients with ? 1 RF, while patients with > 1 RF had poor prognoses irrespective of the location of recurrence.

SUBMITTER: Baek JY

PROVIDER: S-EPMC7779728 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Survival and Prognostic Factors for Breast Cancer Patients with Regional Oligo-Recurrence.

Baek Jong Yun JY Choi Doo Ho DH Park Won W Kim Haeyoung H Cho Won Kyung WK Yoo Gyu Sang GS

Journal of breast cancer 20201201 6

<h4>Purpose</h4>This study aimed to evaluate survival outcomes and identify prognostic factors for regional oligo-recurrence in breast cancer patients who received salvage local treatment.<h4>Methods</h4>In the breast cancer registry of our institution, 18,790 patients received curative surgery for stage I-III breast cancer between January 1995 and June 2016. Of those patients, only 87 (0.5%)underwent salvage local treatment for isolated nodal recurrence on the axillary lymph nodes (ALNs) (n = 5 ...[more]

PMID: 33408888

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Project description:Importance:It is not well understood whether prognostic factors in breast cancer are affected by specific treatment and vary by clinical outcome type compared with untreated patients. Objective:To identify independent clinical and molecular measurements associated with overall survival (OS) and recurrence-free survival (RFS) by homogeneous treatment in women with breast cancer. Design, Setting, and Participants:This prognostic study included 956 patients diagnosed with invasive breast cancer from hospital centers across 4 geographical regions of the United States who participated in the accreditation program of the Commission on Cancer of the American College of Surgeons from 1985 to 1997. The duration of follow-up ranged from 1 to 282 months. The study analysis was conducted from June 10, 2019, to March 18, 2020. Main Outcomes and Measures:Analysis of OS and RFS in patients who underwent chemotherapy, radiotherapy, or endocrine therapy alone compared with no systemic or locoregional therapy. Cox proportional hazards regression models were used to estimate independent performance and 95% CI of age, tumor size, number of positive nodes (nodal status), tumor grades 2 and 3, p53 status, estrogen receptor (ER) status, and ERBB2 (formerly HER2) status. Results:Among 956 participants, median age was 61 (range, 25-96) years. Age (adjusted hazard ratio [AHR], 2.24; 95% CI, 1.27-3.94; P?=?.01) and high grade (AHR, 2.05; 95% CI, 1.09-3.86; P?=?.02), in addition to nodal status and tumor size, were independently associated with OS and RFS, respectively, in untreated patients. p53 status (AHR, 2.11; 95% CI, 1.07-4.18; P?=?.03) and ER status (AHR, 0.46; 95% CI, 0.23-0.92; P?=?.03) were associated with higher and lower risks of death, respectively, whereas nodal status (AHR, 1.13; 95% CI, 1.06-1.20; P?<?.005), high grade (AHR, 4.01; 95% CI, 1.51-10.70; P?=?.01), and ERBB2 positivity (AHR, 2.67; 95% CI, 1.25-5.70; P?=?.01) were associated with the risk of recurrence after endocrine therapy. Tumor size (AHR for OS, 2.76 [95% CI, 1.79-4.31; P?<?.005]; AHR for RFS, 2.27 [95% CI, 1.23-4.18; P?=?.01]) and ERBB2 status (AHR for OS, 5.35 [95% CI, 1.31-21.98; P?=?.02]; AHR for RFS, 6.05 [95% CI, 1.48-24.78; P?=?.01]) were independently associated with radiotherapy outcomes, and nodal status was significantly associated with chemotherapy outcomes (AHR for OS, 1.06 [95% CI, 1.02-1.09; P?<?.005]; AHR for RFS, 1.05 [95% CI, 1.01-1.09; P?=?.01]). Conclusions and Relevance:In this study, independent prognostic factors were associated with specific treatment and weighted by the outcome category with reference to untreated patients within biological and clinical contexts.

Project description:Breast cancer recurrence (BCR) is a common treatment outcome despite curative-intent primary treatment of non-metastatic breast cancer. Currently used prognostic and predictive factors utilize tumor-based markers, and are not optimal determinants of risk of BCR. Germline-based copy number aberrations (CNAs) have not been evaluated as determinants of predisposition to experience BCR. In this study, we accessed germline DNA from 369 female breast cancer subjects who received curative-intent primary treatment following diagnosis. Of these, 155 experienced BCR and 214 did not, after a median duration of follow up after breast cancer diagnosis of 6.35 years (range?=?0.60-21.78) and 8.60 years (range?=?3.08-13.57), respectively. Whole genome CNA genotyping was performed on the Affymetrix SNP array 6.0 platform. CNAs were identified using the SNP-Fast Adaptive States Segmentation Technique 2 algorithm implemented in Nexus Copy Number 6.0. Six samples were removed due to poor quality scores, leaving 363 samples for further analysis. We identified 18,561 CNAs with ?1 kb as a predefined cut-off for observed aberrations. Univariate survival analyses (log-rank tests) identified seven CNAs (two copy number gains and five copy neutral-loss of heterozygosities, CN-LOHs) showing significant differences (P<2.01×10(-5)) in recurrence-free survival (RFS) probabilities with and without CNAs.We also observed three additional but distinct CN-LOHs showing significant differences in RFS probabilities (P<2.86×10(-5)) when analyses were restricted to stratified cases (luminal A, n?=?208) only. After adjusting for tumor stage and grade in multivariate analyses (Cox proportional hazards models), all the CNAs remained strongly associated with the phenotype of BCR. Of these, we confirmed three CNAs at 17q11.2, 11q13.1 and 6q24.1 in representative samples using independent genotyping platforms. Our results suggest further investigations on the potential use of germline DNA variations as prognostic markers in cancer-associated phenotypes.

Dataset Information

Survival and Prognostic Factors for Breast Cancer Patients with Regional Oligo-Recurrence.

Purpose

Methods

Results

Conclusion

Publications

Survival and Prognostic Factors for Breast Cancer Patients with Regional Oligo-Recurrence.

Similar Datasets

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