Survival outcome of adjuvant chemotherapy and high 21‐gene recurrence score in early‐stage breast cancer
| Autor: | Oluwadamilola T. Oladeru, Anurag K. Singh, Sung Jun Ma, Maryann Mikucki, Mark K. Farrugia, Austin J. Iovoli, Amit Sood, Rohil Shekher |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
medicine.medical_specialty Adjuvant chemotherapy medicine.medical_treatment Population Breast Neoplasms Survival outcome 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine Epidemiology Internal Medicine medicine Humans Stage (cooking) education education.field_of_study Chemotherapy business.industry medicine.disease Chemotherapy Adjuvant 030220 oncology & carcinogenesis Propensity score matching Female Surgery Neoplasm Recurrence Local business |
| Zdroj: | The Breast Journal. 27:27-34 |
| ISSN: | 1524-4741 1075-122X |
| DOI: | 10.1111/tbj.14130 |
| Popis: | Among patients with early-stage breast cancer and a high 21-gene recurrence score (RS) ≥ 26, it remains unclear on whether those with RS 26-30 would benefit from chemotherapy with a comparable magnitude as those with RS 30. In addition, RS 30 as an independent prognostic factor for breast cancer-specific survival (BCSS) and overall survival (OS) compared to RS 26-30 also remains unclear. The Surveillance, Epidemiology, and End Results (SEER) database was queried for patients diagnosed between 2010 and 2013 with hormone receptor-positive, HER2-negative, and T1-2N0 breast cancer with a RS ≥ 26. Primary end points were OS and BCSS, evaluated by using Kaplan-Meier method, log-rank test, and Cox multivariable analysis. Subgroups of RS 26-30 and RS 30 were examined using propensity score matching to address selection bias. Among 5054 patients who met the inclusion criteria, adjuvant chemotherapy was associated with improved OS (HR 0.66, 95% CI 0.53-0.83, P .001) and BCSS (HR 0.61, 95% CI 0.45-0.83, P = .001). In the subgroup of 943 matched pairs of patients with RS 26-30, the addition of chemotherapy remained statistically significant (OS: HR 0.52, 95% CI 0.34-0.79, P = .003; BCSS: HR 0.42, 95% CI 0.22-0.81, P = .009). Among 1194 matched pairs who underwent adjuvant chemotherapy, those with RS 30 had worse outcomes than others with RS 26-30 (OS: HR 1.68, 95% CI 1.17-2.42, P = .005; BCSS: HR 1.92, 95% CI 1.17-3.15, P = .01). Our study builds on prior literature using a population-based database to suggest the association of adjuvant chemotherapy with improved survival among those with RS 26-30 and worse mortality associated with RS 30 compared to RS 26-30. |
| Databáze: | OpenAIRE |
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