Literature DB >> 28387923

The role of postmastectomy radiotherapy in women with pathologic T3N0M0 breast cancer.

Richard J Cassidy1,2, Yuan Liu3, Shannon T Kahn1,2, Naresh K Jegadeesh1,2, Xi Liu3, Preeti D Subhedar2,4, Cletus A Arciero2,4, Theresa W Gillespie2,4, Mylin A Torres1,2.   

Abstract

BACKGROUND: The authors determined the impact of postmastectomy radiotherapy (PMRT) on overall survival (OS) among patients with pT3N0M0 breast cancer in the National Cancer Data Base.
METHODS: A total of 3437 patients with pT3N0M0 breast cancer who initially were treated with mastectomy between 2003 and 2011 were identified. Of these women, 1644 (47.8%) received PMRT (67% treated with chest wall RT alone and 33% treated with chest wall and regional lymph node irradiation). Univariable and multivariable analyses were conducted to identify characteristics associated with PMRT and OS. In addition, propensity score matching and interaction effect testing also were performed.
RESULTS: PMRT was associated with age <40 years, private insurance coverage, treatment facility location within 10 miles of the patient's home zip code, Charlson-Deyo comorbidity score of 0, tumor size ≥7 cm, and treatment with chemotherapy or hormone therapy (all P<.05). PMRT was associated with improved 5-year OS (86.3% for patients treated with PMRT vs 66.4% for patients not treated with PMRT; P<.01). In addition to PMRT (hazard ratio, 0.72; 95% confidence interval, 0.59-0.87 [P<.01]), age ≤50 years, treatment at an academic/research program, Charlson-Deyo comorbidity score of 0, tumor size <7 cm, chemotherapy receipt, and hormone therapy receipt were associated with improved OS on multivariable analyses (all P<.05). Interaction testing found that PMRT improved OS independent of age, facility type, Charlson-Deyo comorbidity score, tumor grade and size, surgical margin status, and receipt of chemotherapy or hormone therapy (all P>.1). Finally, propensity score matching analysis confirmed the impact of PMRT on OS (P = .02). It is interesting to note that regional lymph node irradiation did not improve OS versus chest wall RT alone (P = .09).
CONCLUSIONS: Among patients with pT3N0M0 breast cancer in the National Cancer Data Base, PMRT was found to be associated with improved OS regardless of surgical margin status, tumor size, and receipt of systemic therapy. Cancer 2017;123:2829-39.
© 2017 American Cancer Society. © 2017 American Cancer Society.

Entities:  

Keywords:  National Cancer Data Base (NCDB); breast cancer; health disparities; pT3N0; postmastectomy radiotherapy; regional lymph node radiation

Mesh:

Substances:

Year:  2017        PMID: 28387923     DOI: 10.1002/cncr.30675

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  7 in total

Review 1.  Individualization of post-mastectomy radiotherapy and regional nodal irradiation based on treatment response after neoadjuvant chemotherapy for breast cancer : A systematic review.

Authors:  David Krug; René Baumann; Wilfried Budach; Jürgen Dunst; Petra Feyer; Rainer Fietkau; Wulf Haase; Wolfgang Harms; Thomas Hehr; Marc D Piroth; Felix Sedlmayer; Rainer Souchon; Frederik Wenz; Rolf Sauer
Journal:  Strahlenther Onkol       Date:  2018-01-30       Impact factor: 3.621

Review 2.  When Can We Avoid Postmastectomy Radiation Following Primary Systemic Therapy?

Authors:  Ángel Montero; Raquel Ciérvide; Philip Poortmans
Journal:  Curr Oncol Rep       Date:  2019-10-29       Impact factor: 5.075

3.  Outcomes in Patients with pT3N0M0 Breast Cancer with and without Postmastectomy Radiotherapy.

Authors:  Chunyan Li; Jiangfeng Wang; Miao Mo; Jing Yuan; Jurui Luo; Kairui Jin; Xuanyi Wang; Yilan Yang; Jinli Ma; Xin Mei; Zhaozhi Yang; Xiaoli Yu; Xingxing Chen; Xiaomao Guo
Journal:  Cancer Manag Res       Date:  2021-05-13       Impact factor: 3.989

4.  Postmastectomy Radiation Therapy for Node-Negative Breast Cancer of 5 cm or Larger Tumors: A Multicenter Retrospective Analysis (KROG 20-03).

Authors:  Kyubo Kim; Jinhong Jung; Haeyoung Kim; Wonguen Jung; Kyung Hwan Shin; Ji Hyun Chang; Su Ssan Kim; Won Park; Jee Suk Chang; Yong Bae Kim; Sung Ja Ahn; Ik Jae Lee; Jong Hoon Lee; Hae Jin Park; Jihye Cha; Juree Kim; Jin Hwa Choi; Taeryool Koo; Jeanny Kwon; Jin Hee Kim; Mi Young Kim; Shin-Hyung Park; Yeon-Joo Kim
Journal:  Cancer Res Treat       Date:  2021-08-25       Impact factor: 4.679

5.  Prognostic validation and therapeutic decision-making of the AJCC eighth pathological prognostic staging for T3N0 breast cancer after mastectomy.

Authors:  San-Gang Wu; Jun Wang; Jian Lei; Chen-Lu Lian; Li Hua; Juan Zhou; Zhen-Yu He
Journal:  Clin Transl Med       Date:  2020-04-23

6.  Partial chest wall radiation therapy for positive or close surgical margins after modified radical mastectomy for breast cancer without lymph node metastasis.

Authors:  Naoya Ishibashi; Haruna Nishimaki; Toshiya Maebayashi; Keita Adachi; Kenichi Sakurai; Shinobu Masuda; Masaharu Hata; Masahiro Okada
Journal:  Asia Pac J Clin Oncol       Date:  2019-11-05       Impact factor: 2.601

7.  The Survival Effect of Chest Wall With or Without Regional Lymphatic Radiotherapy for Breast Cancer Patients With T3~4N0M0.

Authors:  Guanqiao Li; Jia Yao; Junni Chen; Baizhen Cai; Xiangying Lin; Zetan Chen; Jiawei Chen; Han Wang; Shiping Yang
Journal:  Front Oncol       Date:  2021-07-12       Impact factor: 6.244

  7 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.