Risk factors for locoregional disease recurrence after breast-conserving therapy in patients with breast cancer treated with neoadjuvant chemotherapy: An international collaboration and individual patient meta-analysis

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Risk factors for locoregional disease recurrence after breast-conserving therapy in patients with breast cancer treated with neoadjuvant chemotherapy : An international collaboration and individual patient meta-analysis

Valachis, Antonios, 1984- (author): Uppsala universitet,Experimentell och klinisk onkologi,Centrum för klinisk forskning i Sörmland (CKFD)

Mamounas, Eleftherios P. (author): Comprehensive Breast Program, University of Florida Health Cancer Center‐Orlando Health, Orlando, Florida,Univ Florida, Hlth Canc Ctr Orlando Hlth, Comprehens Breast Program, Orlando, FL USA

Mittendorf, Elizabeth A. (author): Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas,Univ Texas MD Anderson Canc Ctr, Dept Breast Surg Oncol, Houston, TX 77030 USA

Hayashi, Naoki (author): Department of Breast Surgery, St. Luke's International Hospital, Tokyo, Japan,St Lukes Int Hosp, Dept Breast Surg, Tokyo, Japan

Ishitobi, Makoto (author): Department of Breast Surgery, Osaka International Cancer Institute, Osaka, Japan; Department of Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan,Osaka Int Canc Inst, Dept Breast Surg, Osaka, Japan;Osaka Int Canc Inst, Dept Endocrine Surg, Osaka, Japan

Natoli, Clara (author): Department of Oral, Medical and Biotechnological Sciences, University G. D'Annunzio, Chieti‐Pescara, Italy,Univ G DAnnunzio, Dept Oral Med & Biotechnol Sci, Chieti, Italy

Fitzal, Florian (author): Department of Surgery, Breast Health Center, Medical University Vienna, Vienna, Austria,Med Univ Vienna, Dept Surg, Breast Hlth Ctr, Vienna, Austria

Rubio, Isabel T. (author): Breast Surgical Oncology, Breast Cancer Center, University Hospital VAll d'Hebron, Barcelona, Spain,Univ Hosp VAll dHebron, Breast Canc Ctr, Breast Surg Oncol, Barcelona, Spain

Tiezzi, Daniel G. (author): Breast Disease Division, Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil,Univ Sao Paulo, Ribeirao Preto Med Sch, Breast Dis Div, Dept Gynecol & Obstet, Sao Paulo, Brazil

Shin, Hee-Chul (author): Department of Surgery, Chung‐Ang University Hospital, Seoul, South Korea,Chung Ang Univ Hosp, Dept Surg, Seoul, South Korea

Anderson, Stewart J. (author): National Surgical Adjuvant Breast and Bowel Project Biostatistical Center, Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Natl Surg Adjuvant Breast & Bowel Project,Biostat, Pittsburgh, PA 15261 USA

Hunt, Kelly K. (author): Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas,Univ Texas MD Anderson Canc Ctr, Dept Breast Surg Oncol, Houston, TX 77030 USA

Matsuda, Naoko (author): Department of Breast Surgery, St. Luke's International Hospital, Tokyo, Japan,St Lukes Int Hosp, Dept Breast Surg, Tokyo, Japan

Ohsumi, Shozo (author): Department of Breast Oncology, NHO Shikoku Cancer Center, Matsuyama, Japan,NHO Shikoku Canc Ctr, Dept Breast Oncol, Matsuyama, Ehime, Japan

Totomi, Athina (author): Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD)

Nilsson, Cecilia (author): Centre for Clinical Research, Vastmanlands County Hospital, Vasteras, Sweden,Vastmanlands Cty Hosp, Ctr Clin Res, Vasteras, Sweden

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2018-05-03
2018
English.
In: Cancer. - : John Wiley & Sons. - 0008-543X .- 1097-0142. ; 124:14, s. 2923-2930

Related links:: https://doi.org/10.1...; show more...; https://acsjournals....; https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: Several studies have reported a high risk of local disease recurrence (LR) and locoregional disease recurrence (LRR) in patients with breast cancer after neoadjuvant chemotherapy (NCT) and breast-conserving therapy (BCT). The objective of the current study was to identify potential risk factors for LR and LRR after NCT and BCT.METHODS: Individual patient data sets from 9 studies were pooled. The outcomes of interest were the occurrence of LR and/or LRR. A 1-stage meta-analytic approach was used. Cox proportional hazards regression models were applied to identify factors that were predictive of LR and LRR, respectively.RESULTS: A total of 9 studies (4125 patients) provided their data sets. The 10-year LR rate was 6.5%, whereas the 10-year LRR rate was 10.3%. Four factors were found to be associated with a higher risk of LR: 1) estrogen receptor-negative disease; 2) cN + disease; 3) a lack of pathologic complete response in axilla (pN0); and 4) pN2 to pN3 disease. The predictive score for LR determined 3 risk groups: a low-risk, intermediate-risk, and high-risk group with 10-year LR rates of 4.0%, 7.9%, and 20.4%, respectively. Two additional factors were found to be associated with an increased risk of LRR: cT3 to cT4 disease and a lack of pathologic complete response in the breast. The predictive score for LRR determined 3 risk groups; a low-risk, intermediate-risk, and high-risk group with 10-year LRR rates of 3.2%, 10.1%, and 24.1%, respectively.CONCLUSIONS: BCT after NCT appears to be an oncologically safe procedure for a large percentage of patients with breast cancer. Two easy-to-use clinical scores were developed that can help clinicians to identify patients at higher risk of LR and LRR after NCT and BCT and individualize the postoperative treatment plan and follow-up.

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By the author/editor: Valachis, Antoni ...; Mamounas, Elefth ...; Mittendorf, Eliz ...; Hayashi, Naoki; Ishitobi, Makoto; Natoli, Clara; show more...; Fitzal, Florian; Rubio, Isabel T.; Tiezzi, Daniel G ...; Shin, Hee-Chul; Anderson, Stewar ...; Hunt, Kelly K.; Matsuda, Naoko; Ohsumi, Shozo; Totomi, Athina; Nilsson, Cecilia; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

Articles in the publication: Cancer

By the university: Örebro University; Uppsala University

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Risk factors for locoregional disease recurrence after breast-conserving therapy in patients with breast cancer treated with neoadjuvant chemotherapy : An international collaboration and individual patient meta-analysis

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