Survival outcomes and prognostic analysis in triple-negative invasive lobular carcinoma: A SEER database study

Abstract Background : The benefit of adjuvant chemotherapy in invasive lobular carcinoma (ILC) is still unclear. The objective of the current study was to elucidate the effectiveness of adjuvant chemotherapy in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, pT1b-c/N0-1/M0 ILC. Methods: Based on Surveillance, Epidemiology, and End-Results (SEER) database, we identified original 12334 HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC patients, who were then divided into adjuvant chemotherapy group and control group. End-points were overall survival (OS) and breast cancer-specific mortality (BCSM). Aiming to minimize the selection bias of baseline characteristics, Propensity Score Matching (PSM) method was used. Results : In a total of 12334 patients with HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC, 1785 patients (14.5%) were allocated into adjuvant chemotherapy group and 10549 (85.5%) into control group. Used PSM, the 1785 patients in adjuvant chemotherapy group matched to the 1785 patients in control group. By Kaplan-Meier survival analyses, we observed no beneficial effect of adjuvant chemotherapy on OS in both original samples ( P =0.639) and matched samples ( P =0.962), however, ineffective or even contrary results of adjuvant chemotherapy on BCSM both in original samples (P =0.001) and in matched samples ( P= 0.002). In both original and matched multivariate Cox models, we observed ineffectiveness of adjuvant chemotherapy on OS (hazard ratio (HR) for overall survival = 0.82, 95% confidence interval (CI) [0.62-1.09]; P =0.172 and HR=0.90, 95%CI [0.65-1.26]; P =0.553, respectively), unexpectedly promoting effect of adjuvant chemotherapy on BCSM (HR=2.33, 95%CI [1.47-3.67]; P =0.001 and HR=2.41, 95%CI [1.32-4.39]; P =0.004, respectively). Standard surgery was beneficial to the survival of patients. Lymph node metastasis was detrimental to survival and radiotherapy brought survival benefit in original samples, but two issues had unobvious effect in matched samples. Conclusion: In this study, adjuvant chemotherapy did not improve survival for patients with HR-positive, HER2-negative pT1b-c/N0-1/M0 ILC.

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Adjuvant chemotherapy could not bring survival benefit to HR-positive, HER2-negative, pT1b-c/N0-1/M0 invasive lobular carcinoma of the breast: a propensity score matching study based on SEER database

10.21203/rs.2.16869/v1 ◽

2019 ◽

Author(s):

Guangfu Hu ◽

Guangxia Hu ◽

Chengjiao Zhang ◽

Xiaoyan Lin ◽

Ming Shan ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Propensity Score ◽

Propensity Score Matching ◽

Invasive Lobular Carcinoma ◽

Survival Benefit ◽

Lobular Carcinoma ◽

Control Group ◽

Seer Database ◽

Chemotherapy Group ◽

Matched Samples

Abstract Background : The benefit of adjuvant chemotherapy in invasive lobular carcinoma (ILC) is still unclear. The objective of the current study was to elucidate the effectiveness of adjuvant chemotherapy in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, pT1b-c/N0-1/M0 ILC. Methods: Based on Surveillance, Epidemiology, and End-Results (SEER) database, we identified original 13996 HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC patients, who were then divided into adjuvant chemotherapy group and control group. End-points were overall survival (OS) and breast cancer-specific mortality (BCSM). Aiming to minimize the selection bias of baseline characteristics, Propensity Score Matching (PSM) method was used. Results : In a total of 13996 patients with HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC, 1800 patients (12.9%) were allocated into adjuvant chemotherapy group and 12196 (87.1%) into control group. Used PSM, the 1800 patients in adjuvant chemotherapy group matched to the 1800 patients in control group. By Kaplan-Meier survival analyses, we observed beneficial effect of adjuvant chemotherapy on OS in original samples ( P =0.001) but ineffectiveness in matched samples ( P =0.400), however, ineffective or even contrary results of adjuvant chemotherapy on BCSM both in original samples (P =0.001) and in matched samples ( P= 0.033). In both original and matched multivariate Cox models, we observed ineffectiveness of adjuvant chemotherapy on OS (hazard ratio (HR) for overall mortality = 1.243, 95% confidence interval (CI) [0.954-1.619]; P =0.108 and HR=1.227, 95%CI [0.870-1.731]; P =0.244, respectively), unexpectedly promoting effect of adjuvant chemotherapy on BCSM (HR=2.446, 95%CI [1.598-3.742]; P =0.001 and HR=1.791, 95%CI [1.056-3.037]; P = 0.031, respectively). Lymph node metastasis was detrimental to survival in original samples, but had unobvious effect in matched samples. Radiotherapy and standard surgery were beneficial to the survival of patients. Conclusion: Adjuvant chemotherapy could bring no survival benefit to HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC, even contribute to BCSM.

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Triple negative invasive lobular carcinoma of the breast presents as small bowel obstruction

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2017.06.002 ◽

2017 ◽

Vol 37 ◽

pp. 79-82

Author(s):

Mariya Khokhlova ◽

Heidi Roppelt ◽

Bradley Gluck ◽

Jingxuan Liu ◽

Kester Haye ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Invasive Lobular Carcinoma ◽

Triple Negative ◽

Lobular Carcinoma ◽

Carcinoma Of The Breast

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Research on Effectiveness of Prior Cancer on Survival Outcomes for Patients with Nonmetastatic Triple-Negative Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of the SEER Database

Journal of Oncology ◽

10.1155/2021/9988624 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Heyan Chen ◽

Lutong Yan ◽

Shengyu Pu ◽

Lizhe Zhu ◽

Huimin Zhang ◽

...

Keyword(s):

Breast Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Reference Value ◽

Breast Conserving Surgery ◽

Survival Outcomes ◽

Seer Database ◽

Term Survival

Introduction. Knowledge of the effect of prior cancer on long-term survival outcomes for patients with nonmetastatic triple-negative breast cancer (TNBC) remained unclear. The aim of this study was to explore and identify the effectiveness of prior cancer on breast cancer-specific death (BCSD) and other cause-specific death (OCSD) in patients with nonmetastatic TNBC. Materials and Methods. Data of 29,594 participants with nonmetastatic TNBC patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. Prognostic predictors were identified by propensity score matching (PSM) analysis combined with univariate cumulative incidence function (CIF) and multivariate Fine and Gray competitive risk analyses. Results. Among the women with nonmetastatic TNBC included in the unmatched cohort, a total of 5,375 (18.2%) subjects had prior cancers (P-TNBC) and 24,219 (81.8%) had no prior cancer (NP-TNBC). Patients with P-TNBC tended to have poorer BCSD (Gray’s test, p = 0.0131 ) and OCSD (Gray’s test, p = 0.0009 ) in comparison with those with NP-TNBC after PSM. However, the risk of BCSD p = 0.291 and OCSD p = 0.084 found no difference among P-TNBC patients with one prior cancer and two or more prior cancers after PSM. Additionally, subjects with younger age, advanced T stage, advanced N stage, and advanced differentiation grade tumors were likely to develop BCSD, whereas those with breast-conserving surgery (BCS), radiotherapy, or chemotherapy tended to have a lower incidence of BCSD. Conclusion. Our study demonstrated that prior cancer was related to the worse BCSD and OCSD rate and could be identified as a reliable survival predictor for patients with nonmetastatic TNBC. This study may provide some reference value for the treatment mode of TNBC patients with prior cancer in the future.

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