Lei Lei1, Han-Ching Chan2, Tzu-Pin Lu2, Skye Hung-Chun Cheng3,4. 1. Breast Oncology Department, Cancer Hospital of the University of Chinese Academy of Sciences, ZheJiang, China. 2. Institute of Epidemiology and Preventive Medicine, Department of Public Health, National Taiwan University, Taipei, Taiwan (ROC). 3. Department of Radiation Oncology, Koo Foundation, Sun Yat-Sen Cancer Center, Taipei, Taiwan (ROC). skyecheng@gmail.com. 4. Taitung Cancer Center, Taitung Christian Hospital, Taitung, Taiwan (ROC). skyecheng@gmail.com.
Abstract
PURPOSE: To assess the prognostic value of the Dutch criteria for patients with early-stage hormone receptor-positive and human epidermal growth factor receptor 2-negative breast cancer from the Taiwan Cancer Registry Database. PATIENTS AND METHODS: We included 8295 patients with early-stage node-negative breast cancer who underwent surgery during January 2008-December 2012. Patients were stratified into low- and high-risk groups based on the Dutch criteria. The Kaplan-Meier method and log-rank test were used to estimate the difference in breast cancer-specific survival (BCSS) and overall survival (OS) between groups. Multivariable analysis was used to evaluate the prognostic value of the Dutch criteria. RESULTS: Overall, the low-risk and high-risk groups comprised 5375 and 2920 patients, respectively. In the low- and high-risk groups, the 5-year BCSS rate was 99.6% and 98.2% (P < 0.0001) and the 5-year OS rate was 98.3% and 96.8% (P < 0.0001), respectively. The hazard ratio for BCSS was 4.18 (95% confidence interval [CI] 2.63-6.63, P < 0.0001), and the hazard ratio for OS was 1.94 (95% CI 1.48-2.55); both were significantly poorer in the high-risk group than in the low-risk group. In the low-risk group, the 5-year BCSS and OS of patients who did and did not receive adjuvant chemotherapy were similar (99.5% versus 99.6% [P = 0.927] and 98.8% and 98.1% [P = 0.0683], respectively). CONCLUSION: The prognosis of low-risk patients as classified using the Dutch criteria is excellent with or without adjuvant chemotherapy. The benefit of multi-gene testing for chemotherapy decision-making might be minimal in these patients.
PURPOSE: To assess the prognostic value of the Dutch criteria for patients with early-stage hormone receptor-positive and humanepidermal growth factor receptor 2-negative breast cancer from the Taiwan Cancer Registry Database. PATIENTS AND METHODS: We included 8295 patients with early-stage node-negative breast cancer who underwent surgery during January 2008-December 2012. Patients were stratified into low- and high-risk groups based on the Dutch criteria. The Kaplan-Meier method and log-rank test were used to estimate the difference in breast cancer-specific survival (BCSS) and overall survival (OS) between groups. Multivariable analysis was used to evaluate the prognostic value of the Dutch criteria. RESULTS: Overall, the low-risk and high-risk groups comprised 5375 and 2920 patients, respectively. In the low- and high-risk groups, the 5-year BCSS rate was 99.6% and 98.2% (P < 0.0001) and the 5-year OS rate was 98.3% and 96.8% (P < 0.0001), respectively. The hazard ratio for BCSS was 4.18 (95% confidence interval [CI] 2.63-6.63, P < 0.0001), and the hazard ratio for OS was 1.94 (95% CI 1.48-2.55); both were significantly poorer in the high-risk group than in the low-risk group. In the low-risk group, the 5-year BCSS and OS of patients who did and did not receive adjuvant chemotherapy were similar (99.5% versus 99.6% [P = 0.927] and 98.8% and 98.1% [P = 0.0683], respectively). CONCLUSION: The prognosis of low-risk patients as classified using the Dutch criteria is excellent with or without adjuvant chemotherapy. The benefit of multi-gene testing for chemotherapy decision-making might be minimal in these patients.
Authors: Joseph A Sparano; Robert J Gray; Peter M Ravdin; Della F Makower; Kathleen I Pritchard; Kathy S Albain; Daniel F Hayes; Charles E Geyer; Elizabeth C Dees; Matthew P Goetz; John A Olson; Tracy Lively; Sunil S Badve; Thomas J Saphner; Lynne I Wagner; Timothy J Whelan; Matthew J Ellis; Soonmyung Paik; William C Wood; Maccon M Keane; Henry L Gomez Moreno; Pavan S Reddy; Timothy F Goggins; Ingrid A Mayer; Adam M Brufsky; Deborah L Toppmeyer; Virginia G Kaklamani; Jeffrey L Berenberg; Jeffrey Abrams; George W Sledge Journal: N Engl J Med Date: 2019-06-03 Impact factor: 91.245
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Authors: Fatima Cardoso; Laura J van't Veer; Jan Bogaerts; Leen Slaets; Giuseppe Viale; Suzette Delaloge; Jean-Yves Pierga; Etienne Brain; Sylvain Causeret; Mauro DeLorenzi; Annuska M Glas; Vassilis Golfinopoulos; Theodora Goulioti; Susan Knox; Erika Matos; Bart Meulemans; Peter A Neijenhuis; Ulrike Nitz; Rodolfo Passalacqua; Peter Ravdin; Isabel T Rubio; Mahasti Saghatchian; Tineke J Smilde; Christos Sotiriou; Lisette Stork; Carolyn Straehle; Geraldine Thomas; Alastair M Thompson; Jacobus M van der Hoeven; Peter Vuylsteke; René Bernards; Konstantinos Tryfonidis; Emiel Rutgers; Martine Piccart Journal: N Engl J Med Date: 2016-08-25 Impact factor: 91.245
Authors: Joseph A Sparano; Robert J Gray; Della F Makower; Kathleen I Pritchard; Kathy S Albain; Daniel F Hayes; Charles E Geyer; Elizabeth C Dees; Edith A Perez; John A Olson; JoAnne Zujewski; Tracy Lively; Sunil S Badve; Thomas J Saphner; Lynne I Wagner; Timothy J Whelan; Matthew J Ellis; Soonmyung Paik; William C Wood; Peter Ravdin; Maccon M Keane; Henry L Gomez Moreno; Pavan S Reddy; Timothy F Goggins; Ingrid A Mayer; Adam M Brufsky; Deborah L Toppmeyer; Virginia G Kaklamani; James N Atkins; Jeffrey L Berenberg; George W Sledge Journal: N Engl J Med Date: 2015-09-27 Impact factor: 91.245
Authors: Andreana N Holowatyj; Michele L Cote; Julie J Ruterbusch; Kristina Ghanem; Ann G Schwartz; Fawn D Vigneau; David H Gorski; Kristen S Purrington Journal: J Clin Oncol Date: 2018-01-17 Impact factor: 44.544