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Assessment of Treatment Sequence in Patients With Stage III Breast Cancer.

Publication ,  Journal Article
Ntowe, KW; Thomas, SM; Dalton, JC; Chiba, A; Woriax, HE; DiLalla, G; DiNome, ML; Plichta, JK
Published in: J Surg Res
August 14, 2024

INTRODUCTION: Stage III breast cancer is defined as locally advanced breast cancer and is treated with curative intent. Historically, overall survival (OS) did not differ based on treatment sequence (neoadjuvant chemotherapy [NAC] followed by surgery versus surgery followed by chemotherapy). Given recent advancements, we examined if treatment sequence may be associated with improved OS in a contemporary cohort of patients with stage III breast cancer. METHODS: Patients aged 18-80 years with prognostic stage III breast cancer who received chemotherapy and surgery were selected from the Surveillance, Epidemiology, and End Results database. Patients were stratified by treatment sequence (NAC versus surgery first). Unadjusted OS and breast cancer-specific survival (BCSS) were estimated using the Kaplan-Meier method and compared with log-rank tests. Cox proportional hazards models were used to estimate the association of treatment sequence with OS and BCSS after adjustment for selected covariates. RESULTS: The study included 26,573 patients; median follow-up was 62.0 months (95% confidence interval [CI] 61.0-63.0). Patients receiving NAC had a worse OS and BCSS compared to those who underwent surgery first (5-year OS rates 0.66 versus 0.73; 5-year BCSS rates 0.70 versus 0.77; both log-rank P < 0.001). After adjustment for tumor subtype, receipt of NAC (versus surgery first) remained associated with a worse OS (hazard ratio 1.27, 95% CI 1.2-1.34, P < 0.001) and BCSS (hazard ratio 1.35, 95% CI 1.27-1.43, P < 0.001). CONCLUSIONS: Based on data from patients treated largely before 2020, undergoing surgery first may be associated with improved survival, even after adjustment for known covariates including tumor subtype. These findings may inform treatment when caring for patients with operable, locally advanced breast cancer.

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Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

August 14, 2024

Volume

302

Start / End Page

347 / 358

Location

United States

Related Subject Headings

  • Surgery
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Chicago
ICMJE
MLA
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Ntowe, K. W., Thomas, S. M., Dalton, J. C., Chiba, A., Woriax, H. E., DiLalla, G., … Plichta, J. K. (2024). Assessment of Treatment Sequence in Patients With Stage III Breast Cancer. J Surg Res, 302, 347–358. https://doi.org/10.1016/j.jss.2024.07.071
Ntowe, Koumani W., Samantha M. Thomas, Juliet C. Dalton, Akiko Chiba, Hannah E. Woriax, Gayle DiLalla, Maggie L. DiNome, and Jennifer K. Plichta. “Assessment of Treatment Sequence in Patients With Stage III Breast Cancer.J Surg Res 302 (August 14, 2024): 347–58. https://doi.org/10.1016/j.jss.2024.07.071.
Ntowe KW, Thomas SM, Dalton JC, Chiba A, Woriax HE, DiLalla G, et al. Assessment of Treatment Sequence in Patients With Stage III Breast Cancer. J Surg Res. 2024 Aug 14;302:347–58.
Ntowe, Koumani W., et al. “Assessment of Treatment Sequence in Patients With Stage III Breast Cancer.J Surg Res, vol. 302, Aug. 2024, pp. 347–58. Pubmed, doi:10.1016/j.jss.2024.07.071.
Ntowe KW, Thomas SM, Dalton JC, Chiba A, Woriax HE, DiLalla G, DiNome ML, Plichta JK. Assessment of Treatment Sequence in Patients With Stage III Breast Cancer. J Surg Res. 2024 Aug 14;302:347–358.
Journal cover image

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

August 14, 2024

Volume

302

Start / End Page

347 / 358

Location

United States

Related Subject Headings

  • Surgery
  • 3202 Clinical sciences
  • 1103 Clinical Sciences