Rachel A Sanford1, Xiudong Lei2, Carlos H Barcenas3, Elizabeth A Mittendorf4, Abigail S Caudle4, Vicente Valero3, Debu Tripathy3, Sharon H Giordano2,3, Mariana Chavez-MacGregor5,6. 1. Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 2. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 3. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. mchavez1@mdanderson.org. 6. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. mchavez1@mdanderson.org.
Abstract
BACKGROUND: No studies have examined the impact of the interval from conclusion of neoadjuvant chemotherapy to surgery in breast cancer patients. This study was undertaken to investigate the relationship between time interval from neoadjuvant chemotherapy to surgery and survival outcomes. METHODS: Breast cancer patients diagnosed with stage I-III disease who received neoadjuvant chemotherapy June 1995 to April 2007 were identified. The effect of neoadjuvant chemotherapy to surgery interval, defined as ≤4, 4-6, or >6 weeks, on survival outcomes was examined. Descriptive statistics and Cox proportional hazards models were used. RESULTS: A total of 1101 patients were identified. Median time to surgery was 33 (range 8-159) days; 335 patients (30.4 %) had surgery within 4 weeks of their last dose of neoadjuvant chemotherapy, 524 (47.6 %) within 4-6 weeks, and 242 (22.0 %) after more than 6 weeks. Median follow-up was 94 (range 3-178) months. The 5-year overall survival (OS) estimates were 79, 87, and 81 % in patients who underwent surgery ≤4, 4-6, and >6 weeks after neoadjuvant chemotherapy, respectively (p = 0.03). The three groups did not differ in 5-year recurrence-free survival (RFS) or locoregional recurrence-free survival (LRFS). In multivariable analysis, compared with an interval of ≤4 weeks, patients who underwent surgery at 4-6 or >6 weeks had equivalent OS, LRFS, and RFS; a sensitivity analysis suggested worse OS in patients who underwent surgery at >8 weeks. CONCLUSIONS: Patients with neoadjuvant chemotherapy to surgery intervals of up to 8 weeks had equivalent OS, RFS, and LRFS.
BACKGROUND: No studies have examined the impact of the interval from conclusion of neoadjuvant chemotherapy to surgery in breast cancerpatients. This study was undertaken to investigate the relationship between time interval from neoadjuvant chemotherapy to surgery and survival outcomes. METHODS:Breast cancerpatients diagnosed with stage I-III disease who received neoadjuvant chemotherapy June 1995 to April 2007 were identified. The effect of neoadjuvant chemotherapy to surgery interval, defined as ≤4, 4-6, or >6 weeks, on survival outcomes was examined. Descriptive statistics and Cox proportional hazards models were used. RESULTS: A total of 1101 patients were identified. Median time to surgery was 33 (range 8-159) days; 335 patients (30.4 %) had surgery within 4 weeks of their last dose of neoadjuvant chemotherapy, 524 (47.6 %) within 4-6 weeks, and 242 (22.0 %) after more than 6 weeks. Median follow-up was 94 (range 3-178) months. The 5-year overall survival (OS) estimates were 79, 87, and 81 % in patients who underwent surgery ≤4, 4-6, and >6 weeks after neoadjuvant chemotherapy, respectively (p = 0.03). The three groups did not differ in 5-year recurrence-free survival (RFS) or locoregional recurrence-free survival (LRFS). In multivariable analysis, compared with an interval of ≤4 weeks, patients who underwent surgery at 4-6 or >6 weeks had equivalent OS, LRFS, and RFS; a sensitivity analysis suggested worse OS in patients who underwent surgery at >8 weeks. CONCLUSIONS:Patients with neoadjuvant chemotherapy to surgery intervals of up to 8 weeks had equivalent OS, RFS, and LRFS.
Authors: Jennifer Y Sheng; Cesar A Santa-Maria; Neha Mangini; Haval Norman; Rima Couzi; Raquel Nunes; Mary Wilkinson; Kala Visvanathan; Roisin M Connolly; Evanthia T Roussos Torres; John H Fetting; Deborah K Armstrong; Jessica J Tao; Lisa Jacobs; Jean L Wright; Elissa D Thorner; Christine Hodgdon; Samantha Horn; Antonio C Wolff; Vered Stearns; Karen L Smith Journal: JCO Oncol Pract Date: 2020-06-30
Authors: Debora de Melo Gagliato; Xiudong Lei; Sharon H Giordano; Vicente Valero; Carlos H Barcenas; Gabriel N Hortobagyi; Mariana Chavez-MacGregor Journal: Oncologist Date: 2020-07-07
Authors: Lauren E Schleimer; Jean-Marie Vianney Dusengimana; John Butonzi; Catherine Kigonya; Abirami Natarajan; Aline Umwizerwa; Daniel S O'Neil; Ainhoa Costas-Chavarri; Jean-Paul Majyambere; Lawrence N Shulman; Nancy L Keating; Cyprien Shyirambere; Tharcisse Mpunga; Lydia E Pace Journal: Surgery Date: 2019-08-27 Impact factor: 3.982