Maoli Wang1, Hongliang Chen2, Kejin Wu1, Ang Ding1, Mingdi Zhang1, Peng Zhang1. 1. Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China. 2. Department of Breast Surgery, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China. Electronic address: 13671852284@163.com.
Abstract
BACKGROUND: The new "prognostic stage" in the 8th edition of the American Joint Committee on Cancer (AJCC) incorporated important biologic factors such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), histologic grade and TNM stage into one system. The objective of this study was to evaluate the "prognostic stage" in locally advanced breast cancer (LABC) based on the Surveillance, Epidemiology, and End Results (SEER) 18 database. METHODS: 10053 LABCs diagnosed between 2010 and 2013 were enrolled. TNM stage was based on AJCC 7th edition. Comparisons of biologic factor proportions among stage changes were performed using Pearson's chi-square test. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier method and log rank testing with pairwise comparisons between different stages was conducted. Cox models were fitted to assess the independent prognostic factors. RESULTS: The prognostic stage grouped LABC into six stages: IB-IIIC among which IB-IIIA had a relatively better survival. It reassigned 74% LABCs to a different tumor stage. 60.4% cases in grade III and 68.3% cases with triple negative breast cancer were upstaged while 57.1% cases with ER/PR dual positivity were down staged. It was an independent prognostic factor of LABC. There were statistically significant survival differences among stage IB-IIIA, IIIB and IIIC. Among each TNM stage, there were statistically significant survival differences among stage changes. CONCLUSIONS: The prognostic stage provided accurate prognostic information for LABC compared with anatomic TNM stage. It will lead to accuracy in prognosis prediction and optimal treatment selection, and therefore, better outcomes.
BACKGROUND: The new "prognostic stage" in the 8th edition of the American Joint Committee on Cancer (AJCC) incorporated important biologic factors such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), histologic grade and TNM stage into one system. The objective of this study was to evaluate the "prognostic stage" in locally advanced breast cancer (LABC) based on the Surveillance, Epidemiology, and End Results (SEER) 18 database. METHODS: 10053 LABCs diagnosed between 2010 and 2013 were enrolled. TNM stage was based on AJCC 7th edition. Comparisons of biologic factor proportions among stage changes were performed using Pearson's chi-square test. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier method and log rank testing with pairwise comparisons between different stages was conducted. Cox models were fitted to assess the independent prognostic factors. RESULTS: The prognostic stage grouped LABC into six stages: IB-IIIC among which IB-IIIA had a relatively better survival. It reassigned 74% LABCs to a different tumor stage. 60.4% cases in grade III and 68.3% cases with triple negative breast cancer were upstaged while 57.1% cases with ER/PR dual positivity were down staged. It was an independent prognostic factor of LABC. There were statistically significant survival differences among stage IB-IIIA, IIIB and IIIC. Among each TNM stage, there were statistically significant survival differences among stage changes. CONCLUSIONS: The prognostic stage provided accurate prognostic information for LABC compared with anatomic TNM stage. It will lead to accuracy in prognosis prediction and optimal treatment selection, and therefore, better outcomes.
Authors: Ananya Gopika Nair; Vasily Giannakeas; John L Semple; Steven A Narod; David W Lim Journal: Ann Surg Oncol Date: 2022-09-08 Impact factor: 4.339
Authors: Jennifer K Plichta; Samantha M Thomas; Amanda R Sergesketter; Rachel A Greenup; Laura H Rosenberger; Oluwadamilola M Fayanju; Gretchen Kimmick; Jeremy Force; Terry Hyslop; E Shelley Hwang Journal: Ann Surg Date: 2022-04-01 Impact factor: 13.787