scholarly journals Radiotherapy after mastectomy has significant survival benefits for inflammatory breast cancer: a SEER population-based retrospective study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8512
Author(s):  
Zhi-wen Li ◽  
Miao Zhang ◽  
Yong-jing Yang ◽  
Zi-jun Zhou ◽  
Yan-ling Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Inflammatory Breast Cancer ◽  
Stage Iv ◽  
Population Based ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Significant Survival ◽  
Study Population

Objectives The survival benefit of postmastectomy radiotherapy (PMRT) has not been fully proven in inflammatory breast cancer (IBC). Thus, in the present research, we aimed at elucidating the effects of PMRT on the survival of IBC patients. Methods Eligible patients were collected from the Surveillance, Epidemiology, and End Results (SEER) dataset between 2010 and 2013. The Kaplan-Meier method along with the log-rank test was utilized for the comparison of both the overall survival (OS) andthe cancer-specific survival (CSS) in patients undergoing PMRT or not. Additionally, multivariate survival analysis of CSS and OS were performed using the Cox proportional hazard model. Results In total, 293 eligible cases were identified, with the median follow-up time of 27 months (range: 5–59 months). After propensity score matching (PSM), 188 patients (94 for each) were classified intothe No-PMRT and the PMRT group. Consequently, significantly higher OS rates were detected in the PMRT group compared with the No-PMRT group prior to PSM (P = 0.034), and significantly higher CSS (P = 0.013) and OS (P = 0.0063) rates were observed following PSM. Furthermore, multivariate analysis revealed thatPMRT [CSS (HR: 0.519, 95% CI [0.287–0.939], P = 0.030); OS (HR: 0.480, 95% CI [0.269–0.859], P = 0.013)], as well as Her2+/HR+ subtype, was independent favorable prognostic factors.Besides, black ethnicity, AJCC stage IV and triple-negative subtype were independent unfavorable prognostic factors. Further subgroup analysis revealed that most of the study population could benefit from PMRT, no matter OS or CSS. Conclusions Our findings support that PMRT could improve the survival of IBC patients.

scholarly journals Risk factors and prognostic factors for inflammatory breast cancer with bone metastasis: A population-based study

2020 ◽  
Author(s):  
Fang Shao
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Prognostic Factors ◽  
Bone Metastasis ◽  
Liver Metastases ◽  
Inflammatory Breast Cancer ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Rare Type ◽  
Cox Proportional Hazard

Abstract Background: Inflammatory breast cancer (IBC) is a rare type of breast cancer with poor prognosis. IBC patients with bone metastasis (BM) often suffer from many complications. This study was to identify risk factors with strong capability of predicting high BM risk for IBC patients and find prognostic factors of IBC patientsMethods: The Surveillance, Epidemiology and End Results (SEER) database was used to collect the clinicopathological and survival information of IBC patients. 966 IBC patients diagnosed between 2010 and 2015 were to study the risk factors for developing BM by using Multivariable logistic regression. 194 and 176 patients were to analyze independent prognostic factors for overall survival (OS) and cancer specific survival (CSS) of IBC patients with BM by performing Cox proportional hazard model.Results: Of the 966 IBC patients, 194 (20.1%) patients were with BM. IBC patients of unmarried, double breast tumor, N1 stage, N3 stage, and liver metastases had higher risk of BM, while those of uninsured status and triple negative breast cancer (TNBC) were less likely to have BM. The survival analysis showed that TNBC subtype and liver metastases were independently significantly associated with poorer OS and CSS of BM patients, while chemotherapy could serve as an independent prognostic factor for better OS and CSS of BM patients.Conclusions: The risk factors for developing BM could provide potential guidelines for screening BM in IBC patients. The independent prognostic factors for survival outcome of IBC patients with BM could help doctors precisely treat those patients.

scholarly journals The different outcomes between breast-conserving surgery plus radiotherapy and mastectomy in metaplastic breast cancer: A population-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256893
Author(s):  
Lin-Yu Xia ◽  
Wei-Yun Xu ◽  
Qing-Lin Hu
Keyword(s):  
Breast Cancer ◽  
Therapeutic Option ◽  
Breast Conserving Surgery ◽  
Population Based ◽  
Survival Outcomes ◽  
Metaplastic Breast Cancer ◽  
Cancer Specific Survival ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Surgical Methods

Background Metaplastic breast cancer (MBC) are rare. The survival outcomes of MBC patients after breast conserving surgery plus radiotherapy (BCS+RT) or mastectomy have not been established. The study aimed to compare survival outcomes of MBC patients subjected to BCS+RT or mastectomy therapeutic options. Methods Patients who were subjected to BCS+RT or mastectomy between 2004 and 2014 were enrolled in this study through the Surveillance, Epidemiology and End Results (SEER) database. Breast cancer-specific survival (BCSS) and the overall survival (OS) of the participants were determined. Cox proportional hazard model and the Kaplan Meier method were used to determine the correlation between the two surgical methods and survival outcomes. Results A total of 1197 patients were enrolled in this study. Among them, 439 patients were subjected to BCS+RT, while 758 patients were subjected to mastectomy. After propensity score matching (PSM), the BCS+RT and mastectomy groups consisted of 321 patients, respectively. The univariate and multivariate analysis with a 6-month landmark all indicate that patients receiving BCS+RT has higher OS than patients receiving mastectomy (HR = 0.701,95% CI = 0.496–0.990, P = 0.044; HR = 0.684,95% CI = 0.479–0.977, P = 0.037) while the BCSS was no difference between the two groups (HR = 0.739,95% CI = 0.474–1.153, P = 0.183; HR = 0.741,95% CI = 0.468–1.173, P = 0.200). Conclusion The BCS+RT therapeutic option exhibits a higher OS in MBC patients compared to the mastectomy approach.

scholarly journals Effect of postmastectomy radiotherapy on T1-2N1M0 triple-negative breast cancer

2021 ◽  
Author(s):  
Lin-Yu Xia ◽  
Wei-Yun Xu ◽  
Zhao Yan
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Population Based ◽  
Positive Lymph Node ◽  
Breast Cancers ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Postmastectomy Radiotherapy ◽  
Cox Proportional Hazard ◽  
Kaplan Meier

Abstract Background: The effect of postmastectomy radiotherapy (PMRT) on T1-2N1M0 triple-negative breast cancers (TNBC) remains unclear. The population-based study aimed to investigate the survival outcomes of T1-2N1M0 TNBC patients who underwent PMRT or not. Methods: We selected 1743 patients with T1-2N1M0 TNBC who underwent mastectomy between 2010 and 2015 through the Surveillance, Epidemiology and End Results (SEER) database. After propensity score matching (PSM) , the PMRT and no-PMRT groups consisted of 586 matched patients, respectively.The Kaplan-Meier method was applied to calculate breast cancer-specific survival (BCSS) and cox proportional hazard model were used to determine the prognostic factors of T1-2N1M0 TNBC.Results: The 5-year BCSS for the PMRT group and no-PMRT group was 79.1% and 74.7%, respectively. TNBC patients with stage T1-2N1M0 receiving PMRT did not show better BCSS than those did not (HR =0.800, 95% CI =0.605-1.056, P =0.115). Subgroup analysis showed that in patients with three nodes positive, radiotherapy could significantly improve BCSS(HR=0.396, 95% CI = 0.175-0.900, P = 0.027), but it brought no significant advantage in BCSS in patients with one or two nodes positive(HR =1.061, 95% CI =0.725-1.552, P =0.761; HR =0.657, 95% CI =0.405-1.065, P =0.088).In addition, PMRT improves the BCSS in TNBC patients with T2 tumor concomitant with three positive lymph nodes(HR =0.343, 95% CI =0.132-0.890, P =0.028).Conclusion: TNBC patients with T2 tumor concomitant with three positive lymph node can benefit from PMRT.

scholarly journals Comparison of survival in non-metastatic inflammatory and other T4 breast cancers: a SEER population-based analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dechuang Jiao ◽  
Jingyang Zhang ◽  
Jiujun Zhu ◽  
Xuhui Guo ◽  
Yue Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Model ◽  
Survival Rates ◽  
Tumor Grade ◽  
Population Based ◽  
Rank Test ◽  
Breast Cancers ◽  
Significant Independent Predictor ◽  
Cancer Specific Survival ◽  
7Th Edition

Abstract Background Previous studies have reported poor survival rates in inflammatory breast cancer (IBC) patients than non-inflammatory local advanced breast cancer (non-IBC) patients. However, until now, the survival rate of IBC and other T4 non-IBC (T4-non-IBC) patients remains unexplored. Methods Surveillance, Epidemiology, and End Results (SEER) database was searched to identify cases with confirmed non-metastatic IBC and T4-non-IBC who had received surgery, chemotherapy, and radiotherapy between 2010 and 2015. IBC was defined as per the American Joint Committee on Cancer (AJCC) 7th edition. Breast Cancer-Specific Survival (BCSS) was estimated by plotting the Kaplan-Meier curve and compared across groups by using the log-rank test. Cox model was constructed to determine the association between IBC and BCSS after adjusting for age, race, stage of disease, tumor grade and surgery type. Results Out of a total of 1986 patients, 37.1% had IBC and mean age was 56.6 ± 12.4. After a median follow-up time of 28 months, 3-year BCSS rate for IBC and T4-non-IBC patients was 81.4 and 81.9%, respectively (log-rank p = 0.398). The 3-year BCSS rate in HR−/HER2+ cohort was higher for IBC patients than T4-non-IBC patients (89.5% vs. 80.8%; log-rank p = 0.028), and in HR−/HER2- cohort it was significantly lower for IBC patients than T4-non-IBC patients (57.4% vs. 67.5%; log-rank p = 0.010). However, it was identical between IBC and T4-non-IBC patients in both HR+/HER2- (85.0% vs. 85.3%; log-rank p = 0.567) and HR+/HER2+ (93.6% vs. 91.0%, log-rank p = 0.510) cohorts. After adjusting for potential confounding variables, we observed that IBC is a significant independent predictor for survival of HR−/HER2+ cohort (hazards ratio [HR] = 0.442; 95% CI: 0.216–0.902; P = 0.025) and HR−/HER2- cohort (HR = 1.738; 95% CI: 1.192–2.534; P = 0.004). Conclusions Patients with IBC and T4-non-IBC had a similar BCSS in the era of modern systemic treatment. In IBC patients, the HR−/HER2+ subtype is associated with a better outcome, and HR−/HER2- subtype is associated with poorer outcomes as compared to the T4-non-IBC patients.

scholarly journals Metastatic behavior and overall survival according to breast cancer subtypes in stage IV inflammatory breast cancer

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
D. J. P. van Uden ◽  
M. C. van Maaren ◽  
L. J. A. Strobbe ◽  
P. Bult ◽  
J. J. van der Hoeven ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Inflammatory Breast Cancer ◽  
Lung Metastases ◽  
Multivariable Analysis ◽  
Stage Iv ◽  
Breast Cancer Subtypes ◽  
Rank Test ◽  
Metastatic Site ◽  
Cancer Subtypes

Abstract Background Distant metastatic disease is frequently observed in inflammatory breast cancer (IBC), with a poor prognosis as a consequence. The aim of this study was to analyze the association of hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) based breast cancer subtypes in stage IV inflammatory breast cancer (IBC) with preferential site of distant metastases and overall survival (OS). Methods For patients with stage IV IBC, diagnosed in the Netherlands between 2005 and 2016, tumors were classified into four breast cancer subtypes: HR+/HER2−, HR+/HER2+, HR−/HER2+, and HR−/HER2−. Patient, tumor, and treatment characteristics and sites of metastases were compared. OS of the subtypes was compared using Kaplan-Meier curves and the log-rank test. Association between subtype and OS was assessed in multivariable models using logistic regression. Results In total, 744 eligible patients were included: 340 (45.7%) tumors were HR+/HER2−, 148 (19.9%) HR−/HER2+, 131 (17.6%) HR+/HER2+, and 125 (16.8%) HR−/HER2−. Bone was the most common metastatic site in all subtypes. A significant predominance of bone metastases was found in HR+/HER2− IBC (71.5%), and liver and lung metastases in the HR−/HER2+ (41.2%) and HR−/HER2− (40.8%) subtypes, respectively. In multivariable analysis, the HR−/HER2− subtype was associated with significantly worse OS as compared to the other subtypes. Conclusion Breast cancer subtypes in stage IV IBC are associated with distinct patterns of metastatic spread and display notable differences in OS. The use of breast cancer subtypes can guide a more patient-tailored staging directed to metastatic site and extend of disease.

Survival outcome of ampullary and duodenal adenocarcinomas.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14579-e14579
Author(s):  
Walid Labib Shaib ◽  
Rahul Sharma ◽  
Sungjin Kim ◽  
Zhengjia Chen ◽  
John S. Kauh ◽  
...  
Keyword(s):  
Early Stage ◽  
Rank Test ◽  
Proportional Hazard ◽  
Equal Distribution ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Survival Difference ◽  
Significant Survival ◽  
Significant Difference ◽  
Emory University

e14579 Background: Adenocarcinomas of the duodenum are divided into two locations: ampullary (AMP) and duodenal (DA). AMP represents 2% of all gastrointestinal (GI) malignancies and commonly present with tumor related obstruction of the common bile duct. DA is rare, and constitutes 0.4% of GI but 45% of small bowel malignancies. The literature regarding treatment and outcome of DA and AMP is very limited. The objective of this project is to evaluate the outcome for these cancers. Methods: After IRB approval, AMP and DA patients were identified from Emory University database. A chart review from July 1995 to July 2012 was conducted. Data was collected for demographic characteristics, pathology, treatment and survival.Survival rates were estimated by Kaplan Meier method and compared with Log-rank test. A Cox proportional hazard model was fitted to estimate the adjusted effect of AMP versus DA on overall survival (OS). Results: A total of 162 patients with AMP (94) and DA (68) were identified. Median age at diagnosis for AMP was 62 and for DA was 63 years. Equal distribution of males and females was found in both locations. No difference was found comparing grade of the tumors. There was a difference in race. DA presented with larger primary tumor compared to AMP. DA presented with advanced stage. Treatment was driven by stage and included surgery, surgery followed by adjuvant chemotherapy (5-FU based) +/- radiation or chemotherapy alone. Median OS of 27.5 for AMP and 19.3 months for DA, not statistically significant difference. Adjusting for stage, no significant survival difference was observed (HR=0.88 95%CI=0.54 – 1.46, p=0.63). Conclusions: Race, size, stage and treatment were different comparing AMP to DA. Majority of AMP had early stage and were treated with surgery; DA tends to present at a late stage. When accounting for stage and location, the OS was not significantly different. [Table: see text]

scholarly journals Neoadjuvant systemic therapy in breast cancer: use and trends in radiotherapy practice

2017 ◽  
Vol 24 (5) ◽  
pp. 310 ◽  
Author(s):  
T.A. Koulis ◽  
K. Beecham ◽  
C. Speers ◽  
S. Tyldesley ◽  
D. Voduc ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systemic Therapy ◽  
Cox Regression ◽  
Population Based ◽  
Prescribing Patterns ◽  
Adjuvant Radiation ◽  
Kaplan Meier ◽  
Survival Difference ◽  
Significant Survival ◽  
Neoadjuvant Systemic Therapy

BackgroundThe use of neoadjuvant systemic therapy (nast) in the treatment of breast cancer is increasing, and the role of adjuvant radiation therapy (rt) in that setting is uncertain. We sought to review and report the use of nast, its trends over time, and its relationship with the prescribing patterns of locoregional rt in a provincial cancer system.Methods Patients with stages i–iii breast cancer diagnosed during 2007–2012 were identified using a provincial database. Patient, tumour, and treatment characteristics were extracted. Multivariable logistic regression analyses were used to assess associations with the use of nast. Kaplan–Meier and Cox regression were used for survival analyses.Results  Of the 11,658 patients who met the inclusion criteria, 602 (5%) had received nast. Use of nast was more frequent in stage iii patients (53%) than in stages i and ii patients (2%). In clinically lymph-node positive patients, a pathology assessment was made approximately 50% of the time. Higher clinical tumour stage and increasing clinical nodal stage predicted for increasing use of nast and of nodal rt after nast, but pathologic nodal status after nast was not associated with use of nodal rt. A statistically significant survival difference was observed between patients in the nast and no-nast groups, but that significance disappeared in a multivariable Cox regression analysis.Conclusions This population-based study demonstrated 5% use of nast for breast cancer. Most patients received nodal rt after nast, and nodal rt was not associated with pathologic stage after nast. Findings likely reflect the realities of clinical practice and show that reliance on clinical nodal staging results in outcomes similar to those reported in the literature.

Evolving Treatment Strategies for Inflammatory Breast Cancer: A Population-Based Survival Analysis

2005 ◽  
Vol 23 (9) ◽  
pp. 1941-1950 ◽  
Author(s):  
Miguel Panades ◽  
Ivo A. Olivotto ◽  
Caroline H. Speers ◽  
Tamara Shenkier ◽  
Theodora A. Olivotto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Analysis ◽  
Inflammatory Breast Cancer ◽  
Estrogen Receptor Status ◽  
Menopausal Status ◽  
Treatment Strategies ◽  
Distant Metastases ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Curative Intent

Purpose To determine if mastectomy (Mx) use, chemotherapy (CT) intensity, or treatment sequence of CT, radiation therapy (RT), and Mx have improved outcome for inflammatory breast cancer (IBC). Patients and Methods A retrospective analysis of 485 patients with IBC diagnosed in British Columbia between 1980 and 2000 analyzed locoregional relapse-free survival (LRFS) and breast cancer–specific survival (BCSS) by treatment intent and treatment received. Curative intent was defined as delivery of more than four cycles of anthracycline-based CT plus locoregional RT in patients without distant metastases. Results Median follow-up among survivors was 6.5 years. Median BCSS was 1.0 and 3.2 years for patients with distant metastases at diagnosis or those who were curatively treated, respectively. Among patients treated curatively (n = 308), there were no significant differences in LRFS or BCSS with timing of Mx before or after CT/RT, time between diagnosis and RT, or the sequence of RT and CT. Patients receiving more intensive CT had improved 10-year BCSS compared with standard CT (43.7% v 26.3%; P = .04). Ten-year LRFS for patients having Mx after CT, Mx before CT, and without Mx was 62.8%, 58.6%, and 34.4%, respectively (P = .0001); the corresponding 10-year BCSS was 36.9%, 19.9%, and 22.5%, respectively (P = .005). On multivariate analysis, Mx was associated with improved LRFS (P = .04). Independent prognostic factors for BCSS were menopausal status (P = .02), estrogen receptor status (P = .02), and CT type (P = .05). Conclusion This retrospective analysis suggested that mastectomy, in conjunction with CT and RT, seemed to enhance locoregional control, whereas modern CT regimens seemed to improve BCSS.

scholarly journals Survival outcomes and prognostic factors for ascending nasopharyngeal carcinoma (T4N0-1) receiving radiation therapy combined with chemotherapy: a population-based study from SEER database.

2020 ◽  
Author(s):  
Fangzheng Wang ◽  
Jiang Chuner ◽  
Piao Yongfeng ◽  
Wang Lei ◽  
Yan Fengqin ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Univariate Analysis ◽  
Population Based ◽  
Rank Test ◽  
Survival Outcomes ◽  
Cancer Specific Survival ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models

Abstract Purpose This study aims to investigate survival outcomes and prognostic factors for upward nasopharyngeal carcinoma (NPC) patients receiving radiation therapy (RT) combined with chemotherapy (CT). Methods A total of 421 previously untreated, newly diagnosed T4N0-1 NPC patients, who were identified within the Surveillance, Epidemiology, and End Results (SEER) registry (years 2004–2015), were collected and retrospectively reviewed. All patients received treatment of RT and CT. Kaplan-Meier analysis was used to evaluate overall survival (OS) and cancer-specific survival (CSS). The differences in OS and CSS were compared using Log-rank test. The independent prognostic factors were established by using univariate and multivariate Cox proportional hazard models. Results With a median follow-up duration of 37 months (range: 3-154 months), the 5-year estimate OS and CSS rates were 59.3% and 63.7%, respectively. N0 and ≥ 65 years were poor prognostic factors for OS and CSS. Moreover, histology and race were associated with OS and CSS. Univariate analysis indicated that ≥ 65 years, N0, NHB and grade III were unfavorable independent prognosticators of OS and CSS. Multivariate analysis demonstrated that ≥ 65 years, N0 and NHB were correlated with poor OS and CSS. Conclusion Patients with stage T4N0-1 NPC receiving RT plus CT had favorable OS and CSS. Moreover, age, N stage and race were independent prognostic factors of OS and CSS.

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