Tree-Based Model for Breast Cancer Prognostication

2004 ◽  
Vol 22 (13) ◽  
pp. 2567-2575 ◽  
Author(s):  
Mousumi Banerjee ◽  
Julie George ◽  
Eun Young Song ◽  
Anuradha Roy ◽  
William Hryniuk
Keyword(s):  
Breast Cancer ◽  
Marital Status ◽  
Tumor Size ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Lymph Node Status ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Significant Difference ◽  
Prognostic Groups

Purpose To define prognostic groups for recurrence-free survival in breast cancer, assess relative effects of prognostic factors, and examine the influence of treatment variations on recurrence-free survival in patients with similar prognostic-factor profiles. Patients and Methods We analyzed 1,055 patients diagnosed with stage I-III breast cancer between 1990 and 1996. Variables studied included socioeconomic factors, tumor characteristics, concurrent medical conditions, and treatment. The primary end point was recurrence-free survival (RFS). Multivariable analyses were performed using recursive partitioning and Cox proportional hazards regression. Results The most significant difference in prognosis was between patients with fewer than four and those with at least four positive nodes (P < .0001). Four distinct prognostic groups (5-year RFS, 97%, 78%, 58%, and 27%) were developed, defined by the number of positive nodes, tumor size, progesterone receptor (PR) status, differentiation, race, and marital status. Patients with fewer than four positive nodes and tumor ≤ 2 cm, PR positive, and well or moderately differentiated had the best prognosis. RFS in this group was unaffected by type of adjuvant therapy (P = .38). Patients with at least four positive nodes and PR-negative tumors had the worst prognosis, and those treated with tamoxifen plus chemotherapy had the best outcome in this group (P = .0001). Among patients in the two intermediate-risk groups, those treated with tamoxifen or a combination of tamoxifen and chemotherapy had the best outcome. Conclusion Lymph node status, PR status, tumor size, differentiation, race, and marital status are valuable for prognostication in breast cancer. The prognostic groups derived can provide guidance for clinical trial design, patient management, and future treatment policy.

Intervals Longer Than 20 Weeks From Breast-Conserving Surgery to Radiation Therapy Are Associated With Inferior Outcome for Women With Early-Stage Breast Cancer Who Are Not Receiving Chemotherapy

2009 ◽  
Vol 27 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Ivo A. Olivotto ◽  
Mary L. Lesperance ◽  
Pauline T. Truong ◽  
Alan Nichol ◽  
Tanya Berrang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Proportional Hazards ◽  
Reference Group ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Cox Proportional Hazards ◽  
Recurrence Free Survival ◽  
Cancer Specific Survival ◽  
Free Survival

PurposeTo determine the interval from breast-conserving surgery (BCS) to radiation therapy (RT) that affects local control or survival.Patients and MethodsThe 10-year Kaplan-Meier (KM) local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), and breast cancer–specific survival (BCSS) were computed for 6,428 women who had T1 to 2, N0 to 1, M0 breast cancer that was diagnosed in British Columbia between 1989 and 2003, and who were treated with BCS and RT without chemotherapy. Intervals from BCS to RT were grouped by weeks as follows: ≤ 4 (n = 83), greater than 4 to 8 (n = 2,288; reference group); greater than 8 to 12 (n = 2,606); greater than 12 to 16 (n = 961); greater than 16 to 20 (n = 358); and greater than 20 weeks (n = 132). Cox proportional hazards models and matching were used to control for confounding variables.ResultsThe median follow-up time was 7.5 years. The 10-year KM outcomes were as follows: LRFS, 95.4%; DRFS, 90.5%; and BCSS, 92.5%. Compared with the greater than 4 to 8 weeks group, hazard ratios (HR) were not significantly different for any outcome among patients who were treated up to 20 weeks after BCS. However, LRFS (hazard ratio [HR], 2.00; P = .15), DRFS (HR, 1.86; P = .02) and BCSS (HR, 2.15; P = .009) were inferior for women with BCS-to-RT intervals greater than 20 weeks compared with those greater than 4 to 8 weeks. The matched analysis yielded similar results.ConclusionOutcomes were statistically similar for BCS-to-RT intervals up to 20 weeks, but they were inferior for intervals beyond 20 weeks. Time can be reasonably allowed for the breast to heal and for patients to consider treatment options, but RT should start within 20 weeks of BCS.

scholarly journals Gene Expression Profile Analysis of T1 and T2 Breast Cancer Reveals Different Activation Pathways

ISRN Oncology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Margit L. H. Riis ◽  
Xi Zhao ◽  
Fateme Kaveh ◽  
Hilde S. Vollan ◽  
Anne-Jorunn Nesbakken ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Profile Analysis ◽  
Distant Metastases ◽  
Molecular Signature ◽  
Receptor Interaction ◽  
Lymph Node Status ◽  
Breast Cancers ◽  
Significant Difference ◽  
T1 And T2

Breast cancers today are of predominantly T1 (0.1≥2.0 cm) or T2 (>2≤5 cm) categories due to early diagnosis. Molecular profiling using microarrays has led to the notion of breast cancer as a heterogeneous disease both clinically and molecularly. Given the prognostic power and clinical use of tumor size, the purpose of this study was to search for molecular signatures characterizing clinical T1 and T2. In total 46 samples were included in the discovery dataset. After adjusting for hormone receptor status, lymph node status, grade, and tumor subclass 441 genes were differently expressed between T1 and T2 tumors. Focal adhesion and extracellular matrix receptor interaction were upregulated in the smaller tumors while p38MAPK signaling and immune-related pathways were more dominant in the larger tumors. The T-size signature was then tested on a validation set of 947 breast tumor samples. Using the T-size expression signatures instead of tumor size leads to a significant difference in risk for distant metastases (P<0.001). If further confirmed, this molecular signature can be used to select patients with tumor category T1 who may need more aggressive treatment and patients with tumor category T2 who may have less benefit from it.

Differences in Male Breast Cancer Stage, Tumor Size at Diagnosis, and Survival Rate Between Metropolitan and Nonmetropolitan Regions

2011 ◽  
Vol 5 (5) ◽  
pp. 430-437 ◽  
Author(s):  
Judith Klein ◽  
Ming Ji ◽  
Nancy K. Rea ◽  
Georjean Stoodt
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Male Breast Cancer ◽  
Tumor Size ◽  
Family Income ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Male Breast ◽  
Cancer Stage ◽  
Survival Differences

Although the incidence for breast cancer in men is lower than for women, male breast cancer (MBC) patients are diagnosed at a later stage and have a higher mortality rate than women. This study examined male cases reported from 1988 through 2006 in the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute for differences in cancer stage, tumor size at diagnosis, and survival rate between metropolitan and nonmetropolitan regions. Pearson’s chi-square was used to evaluate differences in stage and tumor size at diagnosis. Cox proportional hazards regression was used to assess survival differences after adjusting for confounders (race, marital status, median family income, age, and education). Regional differences in tumor grade size and stage at diagnosis were not statistically significant; however, survival differences were observed between metropolitan and nonmetropolitan regions. An interaction between nonmetropolitan area and regional stage MBC was a significant predictor of poorer survival. Raising awareness of MBC in nonmetropolitan areas could save the lives of many men and action should be taken to improve health care access, treatment, and thus prognosis in this population.

Luminal A and Luminal B subtypes in patients with breast cancer 65 years of age and older.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 549-549
Author(s):  
Robert Konigsberg ◽  
Georg Pfeiler ◽  
Nicole Hammerschmid ◽  
Tatjana Klement ◽  
Christian Dittrich
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Endocrine Therapy ◽  
Tumor Size ◽  
Lymph Node Status ◽  
Primary Therapy ◽  
Luminal A ◽  
Ki 67 ◽  
Luminal B ◽  
Significant Difference

549 Background: In 2011, the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer (bc) suggested the distinction between Luminal A and Luminal B subtypes. In Luminal A patients (pts) endocrine therapy seems to be sufficiently effective, whereas in Luminal B pts the additional application of chemotherapy should be considered. It is currently unknown, whether the risk stratification into Luminal A and B is comparably or more discriminatory than the established pathologic tumor size (pT) and lymph node (pN) status in pts ≥ 65 years. This analysis evaluates the discriminatory capacity of the new distinction between Luminal A and B and the established prognostic factors in bc pts ≥ 65 years treated with endocrine therapy only. Methods: Clinico-pathological data of 190 bc pts ≥ 65 years diagnosed between 1998 and 2004 were retrospectively analyzed. Pts were classified as Luminal A [ER (+) and/ or PR (+) and Her/2neu (-) and Ki-67 < 14%] or Luminal B [ER (+) and/ or PR (+) and Her2 (-) and Ki-67 ≥ 14%]. The Kaplan-Meier method was used to assess the progression-free survival (PFS) and overall survival (OS) estimates. Differences in survival between groups were tested for significance by the log-rank test. Results: Median age was 74 years (65–92 years) and median time of follow-up was 69 months (0–134 months). 68.9% and 31.1% pts had Luminal A and B subtypes, respectively. 73.3% and 26.7% of pts had pT1 and pT2 tumors, respectively. 79.7% and 20.3% of pts had pN0 and pN1 status, respectively. Overall, median PFS was 33 months. No significant difference regarding PFS could be detected between Luminal A and B pts, between pT1 and pT2 tumors and between pN0 and pN1 status (p=0.458; 0.172; 0.156), respectively. Overall, median OS was not reached. No significant difference regarding OS could be detected between Luminal A and B pts, between pT1 and pT2 tumors and between pN0 and pN1 status (p=0.328; 0.951; 0.976), respectively. Conclusions: In bc pts ≥ 65 years treated with endocrine therapy only, neither the recently consented dichotomization into Luminal A and B subtypes nor pathologic tumor size and lymph node status could be confirmed to be discriminative as propagated in the 2011 St. Gallen Consensus for the overall bc population.

Leptomeningeal disease and breast cancer: Relationship of outcome and subtype.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 601-601
Author(s):  
Sausan Abouharb ◽  
Joe Ensor ◽  
Monica Elena Loghin ◽  
Ruth Katz ◽  
Ana M. Gonzalez-Angulo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Proportional Hazards ◽  
Treatment Strategies ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Intrathecal Therapy ◽  
Leptomeningeal Disease ◽  
Tumor Subtype ◽  
Dismal Prognosis ◽  
Significant Difference

601 Background: Breast cancer (BC) is one of the most common tumors to involve the leptomeninges. Outcome of leptomeningeal disease (LMD) across BC subtypes is not well documented. We aimed to characterize clinical features and outcomes of LMD based on BC subtypes. Methods: We retrospectively reviewed medical records of patients diagnosed with LMD from BC (1997 to 2012). All patients had BC. Cases of LMD were based on the presence of neoplastic cells on cerebrospinal fluid examination and/or evidence of LMD by imaging studies. Survival was estimated by the Kaplan-Meier method and significant differences in survival were determined by Cox proportional hazards or log-rank tests. Results: 232 patients were included, 189 of them had available tumor subtype classified as: hormone receptor positive (HR+) BC N=67 (35.5%), human epidermal growth factor receptor 2 positive (HER2+) N=55 (29%), and 67 (35.5%) triple-negative BC (TNBC). Median age at diagnosis of LMD was 49.7 years. (Range 24-89). Median overall survival (OS) from LMD diagnosis across all subtypes was 3.1 months (95% CI, 2.5 to 3.7). Median OS correlated with BC subtype: 3.7 months (95% CI: 2.4, 6.0) in HR+, 4.0 months (95% CI: 2.6, 6.9) in HER2+, and 2.2 months (95% CI: 1.5, 3.0) in TNBC, (p=0.0002). There was an 11.4% chance a patient diagnosed with LMD would survive 1 year and the chance of surviving at least 3 years was 1.3%. When age was used as a continuous variable, older age was associated with worse outcome (p<0.0001). Patients with HER2+ BC and LMD were more likely to have received systemic therapy (ST) (70%), compared to HR+ (41%) and TNBC (41%) (p=0.002). 38% of patients with HER2+ BC received HER2 directed therapy. There was no difference in the use of intrathecal therapy (IT) (52%) across subtypes (p=0.3). Use of IT therapy (p<0.0001) and ST (p<0.0001) were both associated with improved age-adjusted OS. After adjusting for age, ST, there was no difference in OS between patients with HR+ and HER2+ BC (p =0.14), but a significant difference remained between TNBC and HER2+ BC (p < 0.0001). Conclusions: LMD carries a dismal prognosis. Our data shows that OS correlates with tumor subtype. Patients with TNBC had a significantly shorter OS compared to patients with HER2+ BC. New treatment strategies are needed.

Racial disparities in cervical cancer mortality over time.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5604-5604
Author(s):  
Jose Alejandro Rauh-Hain ◽  
Marcela G del Carmen ◽  
John O. Schorge ◽  
David M. Boruta ◽  
Whitfield Board Growdon ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Marital Status ◽  
White Women ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
Significant Survival ◽  
Significant Difference ◽  
Over Time ◽  
Related Mortality

5604 Background: The aim of this study is to examine changes over time in survival for African-American (AA) and white women diagnosed with cervical cancer (CeCa). Methods: Surveillance, Epidemiology, and End Results (SEER) Program data 9 for 1983-2007 were used for this analysis. Kaplan–Meier and Cox proportional hazards survival methods were used to assess differences in survival by race at 5-year intervals. Results: The study included 23,722 women; including 19,777 whites and 3,945 AA. AAs were older (51.4 vs. 49 years; p<0.001), had a higher rate of regional (38.3% vs. 31.7; p<0.001) and distant metastasis (10.5% vs. 8.5; p<0.001). AAs received less frequently cancer-directed surgery (53.1% vs. 65.7%; p<0.001), and more frequently radiotherapy (56.9% vs. 47.3%; p<0.001). AAs had a hazard ratio (HR) of 1.40 (95% CI, 1.31-1.49) of CeCa mortality compared to whites. Adjusting for SEER registry, marital status, stage, age, surgery, radiotherapy, grade and histology, AA women had a HR of 1.15 (95% CI, 1.07-1.24) of CeCa related mortality. AAs had a higher HR of all cause mortality and CeCa related mortality for all the five-year diagnosis cohorts (Table). After adjusting for the same variables, there was a significant difference in survival in the 1988-1992 group (HR 1.26; 95% CI 1.09-1.47). Conclusions: The present data indicates significant survival differences by race for women with invasive CeCa. After adjusting for SEER registry, marital status, stage, age, surgery, radiotherapy, grade and histology, only between 1988-1992 there was a difference in survival between the groups. [Table: see text]

scholarly journals Outcome Analysis Among Meningioma Genomic Subgroups Identifies Decreased Recurrence Free Survival in PI3K Activated Tumors

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Mark W Youngblood ◽  
Amar Sheth ◽  
Amy Zhao ◽  
Julio D Montejo ◽  
Daniel Duran ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Outcome Analysis ◽  
Karnofsky Performance Score ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Mutational Signature ◽  
Adjuvant Therapies ◽  
Molecular Features

Abstract INTRODUCTION Previous studies have established relationships between meningioma molecular features and clinical outcome, including deoxyribonucleic acid (DNA)-methylation patterns, TERT promoter mutations, and various chromosomal copy number changes. These relationships stratify patients according to risk of recurrence and progression, thereby guiding difficult postoperative decisions regarding adjuvant therapies and frequency of follow-up. However, the associations of somatic driver mutations with prognosis is relatively less explored, and may yield actionable insights regarding meningioma pathogenesis and patient management. METHODS Available outcome-related data for over 450 meningiomas was collected from retrospective chart review, including extent-of-resection, postoperative therapy, radiological recurrence, long-term clinical events, and Karnofsky performance score. All samples underwent targeted and/or whole-exome sequencing followed by independent classification based on (i) driver mutation and (ii) COSMIC mutational signature. Statistical relationships were investigated between genomic and patient outcome variables using Fisher's exact tests, Kaplan-Meier curves, and Cox proportional hazards modeling. RESULTS We found that KLF4 meningiomas were more likely to illicit long-term symptoms in patients, while POLR2A tumors exhibited the highest average number of years until recurrence. Significant relationships were not identified between mutational signature and outcome. At 5 yr, we observed divergence in recurrence-free survival (RFS) between PI3K activated (AKT1 or PIK3CA mutant) and non-PI3K grade 1 meningiomas. Multivariable Cox proportional hazards analysis confirmed PI3K mutants as an independent significant predictor of RFS from grade, gender, Ki-67, and other established features. CONCLUSION Patients with KLF4-mutant meningiomas, which typically occur in the skull base and with elevated edema, may experience increased incidence of long-term symptoms. Meningiomas harboring activating PI3K mutations exhibit decreased progression free survival, suggesting they could benefit from closer radiologic monitoring or adjuvant therapies. Our results further validate the utility of genomic profiling in meningioma patients, and suggest the need for multimodal molecular integration for optimal prognostic stratification.

scholarly journals Nodal Status and Clinical Outcomes in a Large Cohort of Patients With Triple-Negative Breast Cancer

2011 ◽  
Vol 29 (19) ◽  
pp. 2628-2634 ◽  
Author(s):  
Leonel F. Hernandez-Aya ◽  
Mariana Chavez-MacGregor ◽  
Xiudong Lei ◽  
Funda Meric-Bernstam ◽  
Thomas A. Buchholz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Clinical Outcomes ◽  
Tumor Size ◽  
Large Cohort ◽  
Nodal Status ◽  
Lymph Node Status ◽  
Significant Difference ◽  
Positive Lymph Nodes

Purpose To evaluate the clinical outcomes and relationship between tumor size, lymph node status, and prognosis in a large cohort of patients with confirmed triple receptor–negative breast cancer (TNBC). Patients and Methods We reviewed 1,711 patients with TNBC diagnosed between 1980 and 2009. Patients were categorized by tumor size and nodal status. Kaplan-Meier product limit method was used to calculate overall survival (OS) and relapse-free survival (RFS). A Sidak adjustment was used for multiple group comparisons. Cox proportional hazards models were fit to determine the association of tumor size and nodal status with survival outcomes after adjustment for other patient and disease characteristics. Results Median age was 48 years (range, 21 to 87 years). At a median follow-up of 53 months (range, 0.7 to 317 months), there were 614 deaths and 747 recurrences. The 5-year OS was 80% for node-negative patients (N0), 65% for one to three positive lymph nodes (N1), 48% for four to nine positive lymph nodes (N2), and 44% for ≥ 10 positive lymph nodes (N3; P < .0001). The 5-year RFS rates were 67% for N0, 52% for N1, 36% for N2, and 33% for N3 (P < .0001). Pairwise comparison by nodal status showed that when comparing N0 with node-positive disease, there was a significant difference in OS and RFS (P < .001 all comparisons). However, when comparing N1 with N2 and N3 disease regardless of tumor size, there were no significant differences in OS or RFS. Conclusion In patients with TNBC, once there is evidence of lymph node metastasis, the prognosis may not be affected by the number of positive lymph nodes.

scholarly journals Changes in identification of Her2 status according to 2018 College of American Pathologists/American Society of Clinical Oncology (CAP/ASCO) guideline recommendations for human epidermal growth factor receptor 2 (HER2) fluorescent in situ hybridization (FISH) testing: A real-world study based on consecutive hospital cohort of patients with Her2 IHC 2+ in China (2007-2017)

2019 ◽  
Author(s):  
Ying Xu ◽  
Changjun Wang ◽  
Yi-Dong Zhou ◽  
Feng Mao ◽  
Yan Lin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Tumor Cell ◽  
Copy Number ◽  
Her2 Status ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Significant Difference ◽  
Her 2 ◽  
Er Status

Abstract Background: Trastuzumab has been proved to reduce recurrence and death of Her-2 positive early breast cancer patients. However, the definition of Her-2 positive remains controversial and mutable. The recommendations promoted by ASCO/CAP changed frequently during decades. Although information is available regarding Her2 status and trastuzumab use in the western countries, no related research have been conducted in China to explore the Her-2 status and the utilization of HER2-targeted therapies.Methods: We analysed data from 1,227 patients with histologically proven breast cancer operated in PUMCH from June 2007 to July 2017.There were 1,227 patients with histologically proven Her 2 IHC 2+ breast cancer enrolled in our study. The clinicopathological features, recurrence-free survival (RFS), distant recurrence free survival (DRFS), disease free survival (DFS) and overall survival (OS) were compared among subgroups. Prognostic factors of RFS, DRFS, DFS and OS were identified.Results: Among groups,there was no significant difference in Tumor histology, pT, pTNM stage, Histological grade, Focality, Lymphovascular invasion (LVI), ER, PR, Her2 and Ki67 high (defined as ≥14%) ，surgery of breast，surgery of axilla，percentage of patients who needed chemotherapy, radiation therapy and endocrine therapy. There were significant difference both in the mean age of diagnosis (P=0.005) and different age groups (P=0.003). There was no significant difference in RFS or OS among five groups and between any two groups. There was no significant difference in DRFS and DFS between Group 1 and Group 2 (P=0.011 and P=0.008). According to univariate analyses and Cox multivariate analyses, RFS prognostic factor included pT, LVI and surgery of axilla, pT, pN and ER status were DRFS factors. DFS prognostic factor included pT, pN and PR status. Age at diagnosis, histological type, pT, pN and ER status were prognostic factors of OS.Conclusions: Our study revealed that, according to ASCO/CAP guideline in 2018, compared to patients with HER2-to-CEP17 ratio＜2.0 and average Her2 copy number ＜4.0/tumor cell, the patients with HER2-to-CEP17 ratio＜2.0 and average Her2 copy number ≥4.0 and ＜6/tumor cell showed worse DFS and DRFS. Changing Her2 status of patients with HER2-to-CEP17 ratio＜2.0 and average Her2 copy number ≥4.0 and ＜6/tumor cell from Her2 equivocal to negative seemed not so reasonable.

scholarly journals The impact of preoperative use of calcium channel blockers on outcomes of patients undergoing esophagectomy: a propensity score-matched cohort study

2020 ◽  
Author(s):  
Qihua Lin ◽  
Tianhua Zhang ◽  
Zhijie Wu ◽  
Huiting Li ◽  
Junjie Yu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Scores ◽  
Proportional Hazards ◽  
Perioperative Complications ◽  
Cox Proportional Hazards ◽  
Perioperative Outcomes ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Proportional Hazards Regression ◽  
History Of

Abstract BACKGROUND In this study, we compared the effects of using preoperative CCBs on perioperative outcomes, cancer recurrence and overall survival in patients undergoing esophagectomy. METHODS A retrospective cohort study was performed on patients who underwent esophagectomy at the Sun Yat-Sen University Cancer Center (n=2415, 2009-2013). Univariate and multivariate logistic regression analyses were performed to assess the perioperative outcomes, while recurrence-free survival and overall survival were assessed using Kaplan-Meier survival estimates and compared using a multivariate Cox proportional hazards regression, adjusted with propensity scores. RESULTS There were 162 patients in the CCB group and 1110 patients in the non-CCB group and the total incidence of perioperative complications was 45.7% in the CCB group and 42.5% in the non-CCB group. The differences in total perioperative complications and other perioperative outcomes were not significantly different between the two groups (P>0.05). The mortality rate was not significantly different between the two groups after matching (38.1% vs 31.6%, P=0.233). The difference in recurrence rate between the two groups was not statistically significant after matching (43.2% vs 32.9%, P = 0.061). Overall survival was shorter in patients with preoperative CCB use than in patients without CCB use (hazards ratio: 1.517, 95% confidence intervals (CI): 1.036-2.220, P=0.030). The multivariate Cox proportional hazards regression adjusted with propensity scores found that a history of smoking cigarettes, clinical stage III at diagnosis, preoperative CCB use, preoperative diuretics use, operation type and postoperative chemotherapy affected the overall survival of patients after esophagectomy. Recurrence-free survival was similar between the CCB and non-CCB groups (HR: 1.425, 95%CI: 0.989-2.053, P=0.054). A history of chronic lung disease, hypertension, and preoperative use of beta-blockers affected the recurrence-free survival of patients after esophagectomy. CONCLUSION Preoperative CCBs use was associated with shorter overall survival but did not affect recurrence-free survival or the postoperative complications for patients undergoing esophagectomy.

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