PURPOSE: Theoretically, patients with early breast cancer might benefit from starting adjuvant chemotherapy soon after surgery, and this would have important clinical implications. We have addressed this question from a large, single-center database in which the majority of patients received anthracyclines. PATIENTS AND METHODS: A total of 1161 patients from a prospectively maintained database treated with adjuvant chemotherapy for early breast cancer at the Royal Marsden Hospital (London, United Kingdom), including 686 (59%) receiving anthracyclines, were retrospectively analyzed. The disease-free survival (DFS) and overall survival (OS) of the 368 patients starting chemotherapy within 21 days of surgery (group A) were compared with those of the 793 patients commencing chemotherapy >or= 21 days after surgery (group B). Median follow-up time was 39 months (range, 12 to 147 months). RESULTS: No significant difference in 5-year DFS was found between the two groups overall (70% for group A v 72% for group B; P =.4) or in any subgroup. Likewise, there was no difference in 5-year OS (82% for group A v 84% for group B; P =.2) or when the interval to the start of chemotherapy was considered as a continuous variable (P =.4). CONCLUSION: We have been unable to identify any significant survival benefit from starting adjuvant chemotherapy early after surgery, either overall or in any subset of patients.
PURPOSE: Theoretically, patients with early breast cancer might benefit from starting adjuvant chemotherapy soon after surgery, and this would have important clinical implications. We have addressed this question from a large, single-center database in which the majority of patients received anthracyclines. PATIENTS AND METHODS: A total of 1161 patients from a prospectively maintained database treated with adjuvant chemotherapy for early breast cancer at the Royal Marsden Hospital (London, United Kingdom), including 686 (59%) receiving anthracyclines, were retrospectively analyzed. The disease-free survival (DFS) and overall survival (OS) of the 368 patients starting chemotherapy within 21 days of surgery (group A) were compared with those of the 793 patients commencing chemotherapy >or= 21 days after surgery (group B). Median follow-up time was 39 months (range, 12 to 147 months). RESULTS: No significant difference in 5-year DFS was found between the two groups overall (70% for group A v 72% for group B; P =.4) or in any subgroup. Likewise, there was no difference in 5-year OS (82% for group A v 84% for group B; P =.2) or when the interval to the start of chemotherapy was considered as a continuous variable (P =.4). CONCLUSION: We have been unable to identify any significant survival benefit from starting adjuvant chemotherapy early after surgery, either overall or in any subset of patients.
Authors: Pelagia G Tsoutsou; Yazid Belkacemi; Joseph Gligorov; Abraham Kuten; Hamouda Boussen; Nuran Bese; Michael I Koukourakis Journal: Oncologist Date: 2010-11-01
Authors: John K Chan; James J Java; Katherine Fuh; Bradley J Monk; Daniel S Kapp; Thomas Herzog; Jeffrey Bell; Robert Young Journal: Gynecol Oncol Date: 2016-10-19 Impact factor: 5.482
Authors: Mariana Chavez-MacGregor; Christina A Clarke; Daphne Y Lichtensztajn; Sharon H Giordano Journal: JAMA Oncol Date: 2016-03 Impact factor: 31.777
Authors: Debora de Melo Gagliato; Ana M Gonzalez-Angulo; Xiudong Lei; Richard L Theriault; Sharon H Giordano; Vicente Valero; Gabriel N Hortobagyi; Mariana Chavez-Macgregor Journal: J Clin Oncol Date: 2014-01-27 Impact factor: 44.544