Locoregional risk assessment after neoadjuvant chemotherapy in patients with primary breast cancer: clinical utility of the CPS + EG score
Purpose Locoregional control is a prerequisite to cure primary breast cancer but the prediction of locoregional recurrence to guide further local therapy following neoadjuvant chemotherapy remains a challenge. The CPS + EG score was designed to predict distant recurrences. Here we examine its abilit...
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| Veröffentlicht in: | Breast cancer research and treatment 2019-09, Vol.177 (2), p.437-446 |
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| creator | Michel, Laura L. Sommer, Laura González Silos, Rosa Lorenzo Bermejo, Justo von Au, Alexandra Seitz, Julia Hennigs, André Smetanay, Katharina Golatta, Michael Heil, Jörg Schütz, Florian Sohn, Christof Schneeweiss, Andreas Marmé, Frederik |
| description | Purpose
Locoregional control is a prerequisite to cure primary breast cancer but the prediction of locoregional recurrence to guide further local therapy following neoadjuvant chemotherapy remains a challenge. The CPS + EG score was designed to predict distant recurrences. Here we examine its ability to predict both not only distant but also locoregional recurrences with respect to accuracy and clinical applicability.
Methods
Clinical data from 432 patients with primary breast cancer treated with neoadjuvant chemotherapy between 2003 and 2011 were prospectively collected. Using the Kaplan–Meier method we analyzed the risk of local and distant recurrences according to individual CPS + EG scores, stratified by type of surgery. Possible confounding of the relationship between recurrence risk and CPS + EG score by established risk factors was accounted for in multiple survival regression models. Additionally, we analyzed the performance of the CPS + EG score to predict isolated locoregional recurrence by censoring patients with prior or simultaneous distant metastases.
Results
5-year locoregional recurrence-free survival was 90%, and 5-year distant metastases-free survival was 82%. The CPS + EG score stratified patients into six prognostic groups with distinct 5-year locoregional recurrence-free survival, ranging from 100 to 41% (
p
= 0.02) and 5-year distant metastases-free survival, ranging from 96 to 35% (
p
|
| doi_str_mv | 10.1007/s10549-019-05314-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2246903836</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A594786180</galeid><sourcerecordid>A594786180</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3889-130230b9d0794251d931294c8f510c19122aaf26859290e24bc0118278966183</originalsourceid><addsrcrecordid>eNp9ks-KFDEQxoMo7rj6Ah4kIIggveZPdyfxtgzrKgwouPeQSadnMnYnY5JW5ubViw_pk1izM7quiIQiUPnVl6rkQ-gxJWeUEPEyU9LUqiIUouG0rtQdNKON4JVgVNxFM0JbUbWStCfoQc4bQogSRN1HJ5wy3krKZ-j7ItqY3MrHYAacfP6ITc4u59GFgk1fXMLBRdNtps8GMnbtxljWLpntDvuAt6Z4IDP-4ssab5MfTdrhZXImA2yCdekVtoMP3oL-VPzgyw7HHoMGnr__8OPrtxcQF5c47_t4iO71Zsju0XE_RVevL67mb6rFu8u38_NFZbmUqqKcME6WqiNC1ayhnYKJVG1l31BiqaKMGdOzVjaKKeJYvbSEUsmEVG1LJT9Fzw-y2xQ_TS4XPfps3TAYmHXKmrG6VYRL3gL69C90E6cEj3VNNUpAK_SGWpnBaR_6WJKxe1F93qhaSLiVAHX2DwpW50ZvY3C9h_ytgmd_FKydGco6xwGeMYZ8G2QH0KaYc3K9Pn6FpkTvzaIPZtFgFn1tFq2g6MlxtGk5uu53yS93AMAPQIajsHLpZvb_yP4ErWXIvA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2245973021</pqid></control><display><type>article</type><title>Locoregional risk assessment after neoadjuvant chemotherapy in patients with primary breast cancer: clinical utility of the CPS + EG score</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Michel, Laura L. ; Sommer, Laura ; González Silos, Rosa ; Lorenzo Bermejo, Justo ; von Au, Alexandra ; Seitz, Julia ; Hennigs, André ; Smetanay, Katharina ; Golatta, Michael ; Heil, Jörg ; Schütz, Florian ; Sohn, Christof ; Schneeweiss, Andreas ; Marmé, Frederik</creator><creatorcontrib>Michel, Laura L. ; Sommer, Laura ; González Silos, Rosa ; Lorenzo Bermejo, Justo ; von Au, Alexandra ; Seitz, Julia ; Hennigs, André ; Smetanay, Katharina ; Golatta, Michael ; Heil, Jörg ; Schütz, Florian ; Sohn, Christof ; Schneeweiss, Andreas ; Marmé, Frederik</creatorcontrib><description>Purpose
Locoregional control is a prerequisite to cure primary breast cancer but the prediction of locoregional recurrence to guide further local therapy following neoadjuvant chemotherapy remains a challenge. The CPS + EG score was designed to predict distant recurrences. Here we examine its ability to predict both not only distant but also locoregional recurrences with respect to accuracy and clinical applicability.
Methods
Clinical data from 432 patients with primary breast cancer treated with neoadjuvant chemotherapy between 2003 and 2011 were prospectively collected. Using the Kaplan–Meier method we analyzed the risk of local and distant recurrences according to individual CPS + EG scores, stratified by type of surgery. Possible confounding of the relationship between recurrence risk and CPS + EG score by established risk factors was accounted for in multiple survival regression models. Additionally, we analyzed the performance of the CPS + EG score to predict isolated locoregional recurrence by censoring patients with prior or simultaneous distant metastases.
Results
5-year locoregional recurrence-free survival was 90%, and 5-year distant metastases-free survival was 82%. The CPS + EG score stratified patients into six prognostic groups with distinct 5-year locoregional recurrence-free survival, ranging from 100 to 41% (
p
= 0.02) and 5-year distant metastases-free survival, ranging from 96 to 35% (
p
< 0.0001). 8 patients (17%) with CPS + EG scores ≥ 4 experienced locoregional recurrence—5 of them presented with simultaneous distant disease.
Conclusion
The CPS + EG score, originally designed to predict distant relapse, is also valuable for assessing local recurrence risks. Our data demonstrate that distant and locoregional recurrence risks are closely related. As prognosis of patients with high risk of locoregional failure based on CPS + EG is dominated by distant recurrences, escalating local therapies may have limited impact on overall prognosis.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-019-05314-9</identifier><identifier>PMID: 31236813</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adjuvant treatment ; Adult ; Aged ; Biomarkers, Tumor ; Breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - drug therapy ; Breast Neoplasms - etiology ; Cancer ; Cancer patients ; Cancer research ; Care and treatment ; Chemotherapy ; Chemotherapy, Adjuvant ; Clinical Decision-Making ; Clinical Trial ; Disease Management ; Female ; Humans ; Medical prognosis ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Metastases ; Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Oncology ; Patients ; Prognosis ; Receptors, Estrogen - genetics ; Receptors, Estrogen - metabolism ; Regression analysis ; Risk Assessment ; Risk factors ; Surgery ; Survival ; Treatment Outcome</subject><ispartof>Breast cancer research and treatment, 2019-09, Vol.177 (2), p.437-446</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>COPYRIGHT 2019 Springer</rights><rights>Breast Cancer Research and Treatment is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3889-130230b9d0794251d931294c8f510c19122aaf26859290e24bc0118278966183</citedby><cites>FETCH-LOGICAL-c3889-130230b9d0794251d931294c8f510c19122aaf26859290e24bc0118278966183</cites><orcidid>0000-0002-7784-2826</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-019-05314-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-019-05314-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31236813$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Michel, Laura L.</creatorcontrib><creatorcontrib>Sommer, Laura</creatorcontrib><creatorcontrib>González Silos, Rosa</creatorcontrib><creatorcontrib>Lorenzo Bermejo, Justo</creatorcontrib><creatorcontrib>von Au, Alexandra</creatorcontrib><creatorcontrib>Seitz, Julia</creatorcontrib><creatorcontrib>Hennigs, André</creatorcontrib><creatorcontrib>Smetanay, Katharina</creatorcontrib><creatorcontrib>Golatta, Michael</creatorcontrib><creatorcontrib>Heil, Jörg</creatorcontrib><creatorcontrib>Schütz, Florian</creatorcontrib><creatorcontrib>Sohn, Christof</creatorcontrib><creatorcontrib>Schneeweiss, Andreas</creatorcontrib><creatorcontrib>Marmé, Frederik</creatorcontrib><title>Locoregional risk assessment after neoadjuvant chemotherapy in patients with primary breast cancer: clinical utility of the CPS + EG score</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
Locoregional control is a prerequisite to cure primary breast cancer but the prediction of locoregional recurrence to guide further local therapy following neoadjuvant chemotherapy remains a challenge. The CPS + EG score was designed to predict distant recurrences. Here we examine its ability to predict both not only distant but also locoregional recurrences with respect to accuracy and clinical applicability.
Methods
Clinical data from 432 patients with primary breast cancer treated with neoadjuvant chemotherapy between 2003 and 2011 were prospectively collected. Using the Kaplan–Meier method we analyzed the risk of local and distant recurrences according to individual CPS + EG scores, stratified by type of surgery. Possible confounding of the relationship between recurrence risk and CPS + EG score by established risk factors was accounted for in multiple survival regression models. Additionally, we analyzed the performance of the CPS + EG score to predict isolated locoregional recurrence by censoring patients with prior or simultaneous distant metastases.
Results
5-year locoregional recurrence-free survival was 90%, and 5-year distant metastases-free survival was 82%. The CPS + EG score stratified patients into six prognostic groups with distinct 5-year locoregional recurrence-free survival, ranging from 100 to 41% (
p
= 0.02) and 5-year distant metastases-free survival, ranging from 96 to 35% (
p
< 0.0001). 8 patients (17%) with CPS + EG scores ≥ 4 experienced locoregional recurrence—5 of them presented with simultaneous distant disease.
Conclusion
The CPS + EG score, originally designed to predict distant relapse, is also valuable for assessing local recurrence risks. Our data demonstrate that distant and locoregional recurrence risks are closely related. As prognosis of patients with high risk of locoregional failure based on CPS + EG is dominated by distant recurrences, escalating local therapies may have limited impact on overall prognosis.</description><subject>Adjuvant treatment</subject><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers, Tumor</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - etiology</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Clinical Decision-Making</subject><subject>Clinical Trial</subject><subject>Disease Management</subject><subject>Female</subject><subject>Humans</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Receptors, Estrogen - genetics</subject><subject>Receptors, Estrogen - metabolism</subject><subject>Regression analysis</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Survival</subject><subject>Treatment Outcome</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ks-KFDEQxoMo7rj6Ah4kIIggveZPdyfxtgzrKgwouPeQSadnMnYnY5JW5ubViw_pk1izM7quiIQiUPnVl6rkQ-gxJWeUEPEyU9LUqiIUouG0rtQdNKON4JVgVNxFM0JbUbWStCfoQc4bQogSRN1HJ5wy3krKZ-j7ItqY3MrHYAacfP6ITc4u59GFgk1fXMLBRdNtps8GMnbtxljWLpntDvuAt6Z4IDP-4ssab5MfTdrhZXImA2yCdekVtoMP3oL-VPzgyw7HHoMGnr__8OPrtxcQF5c47_t4iO71Zsju0XE_RVevL67mb6rFu8u38_NFZbmUqqKcME6WqiNC1ayhnYKJVG1l31BiqaKMGdOzVjaKKeJYvbSEUsmEVG1LJT9Fzw-y2xQ_TS4XPfps3TAYmHXKmrG6VYRL3gL69C90E6cEj3VNNUpAK_SGWpnBaR_6WJKxe1F93qhaSLiVAHX2DwpW50ZvY3C9h_ytgmd_FKydGco6xwGeMYZ8G2QH0KaYc3K9Pn6FpkTvzaIPZtFgFn1tFq2g6MlxtGk5uu53yS93AMAPQIajsHLpZvb_yP4ErWXIvA</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Michel, Laura L.</creator><creator>Sommer, Laura</creator><creator>González Silos, Rosa</creator><creator>Lorenzo Bermejo, Justo</creator><creator>von Au, Alexandra</creator><creator>Seitz, Julia</creator><creator>Hennigs, André</creator><creator>Smetanay, Katharina</creator><creator>Golatta, Michael</creator><creator>Heil, Jörg</creator><creator>Schütz, Florian</creator><creator>Sohn, Christof</creator><creator>Schneeweiss, Andreas</creator><creator>Marmé, Frederik</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7784-2826</orcidid></search><sort><creationdate>201909</creationdate><title>Locoregional risk assessment after neoadjuvant chemotherapy in patients with primary breast cancer: clinical utility of the CPS + EG score</title><author>Michel, Laura L. ; Sommer, Laura ; González Silos, Rosa ; Lorenzo Bermejo, Justo ; von Au, Alexandra ; Seitz, Julia ; Hennigs, André ; Smetanay, Katharina ; Golatta, Michael ; Heil, Jörg ; Schütz, Florian ; Sohn, Christof ; Schneeweiss, Andreas ; Marmé, Frederik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3889-130230b9d0794251d931294c8f510c19122aaf26859290e24bc0118278966183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adjuvant treatment</topic><topic>Adult</topic><topic>Aged</topic><topic>Biomarkers, Tumor</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - etiology</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Clinical Decision-Making</topic><topic>Clinical Trial</topic><topic>Disease Management</topic><topic>Female</topic><topic>Humans</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Receptors, Estrogen - genetics</topic><topic>Receptors, Estrogen - metabolism</topic><topic>Regression analysis</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Survival</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Michel, Laura L.</creatorcontrib><creatorcontrib>Sommer, Laura</creatorcontrib><creatorcontrib>González Silos, Rosa</creatorcontrib><creatorcontrib>Lorenzo Bermejo, Justo</creatorcontrib><creatorcontrib>von Au, Alexandra</creatorcontrib><creatorcontrib>Seitz, Julia</creatorcontrib><creatorcontrib>Hennigs, André</creatorcontrib><creatorcontrib>Smetanay, Katharina</creatorcontrib><creatorcontrib>Golatta, Michael</creatorcontrib><creatorcontrib>Heil, Jörg</creatorcontrib><creatorcontrib>Schütz, Florian</creatorcontrib><creatorcontrib>Sohn, Christof</creatorcontrib><creatorcontrib>Schneeweiss, Andreas</creatorcontrib><creatorcontrib>Marmé, Frederik</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Michel, Laura L.</au><au>Sommer, Laura</au><au>González Silos, Rosa</au><au>Lorenzo Bermejo, Justo</au><au>von Au, Alexandra</au><au>Seitz, Julia</au><au>Hennigs, André</au><au>Smetanay, Katharina</au><au>Golatta, Michael</au><au>Heil, Jörg</au><au>Schütz, Florian</au><au>Sohn, Christof</au><au>Schneeweiss, Andreas</au><au>Marmé, Frederik</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Locoregional risk assessment after neoadjuvant chemotherapy in patients with primary breast cancer: clinical utility of the CPS + EG score</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2019-09</date><risdate>2019</risdate><volume>177</volume><issue>2</issue><spage>437</spage><epage>446</epage><pages>437-446</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Purpose
Locoregional control is a prerequisite to cure primary breast cancer but the prediction of locoregional recurrence to guide further local therapy following neoadjuvant chemotherapy remains a challenge. The CPS + EG score was designed to predict distant recurrences. Here we examine its ability to predict both not only distant but also locoregional recurrences with respect to accuracy and clinical applicability.
Methods
Clinical data from 432 patients with primary breast cancer treated with neoadjuvant chemotherapy between 2003 and 2011 were prospectively collected. Using the Kaplan–Meier method we analyzed the risk of local and distant recurrences according to individual CPS + EG scores, stratified by type of surgery. Possible confounding of the relationship between recurrence risk and CPS + EG score by established risk factors was accounted for in multiple survival regression models. Additionally, we analyzed the performance of the CPS + EG score to predict isolated locoregional recurrence by censoring patients with prior or simultaneous distant metastases.
Results
5-year locoregional recurrence-free survival was 90%, and 5-year distant metastases-free survival was 82%. The CPS + EG score stratified patients into six prognostic groups with distinct 5-year locoregional recurrence-free survival, ranging from 100 to 41% (
p
= 0.02) and 5-year distant metastases-free survival, ranging from 96 to 35% (
p
< 0.0001). 8 patients (17%) with CPS + EG scores ≥ 4 experienced locoregional recurrence—5 of them presented with simultaneous distant disease.
Conclusion
The CPS + EG score, originally designed to predict distant relapse, is also valuable for assessing local recurrence risks. Our data demonstrate that distant and locoregional recurrence risks are closely related. As prognosis of patients with high risk of locoregional failure based on CPS + EG is dominated by distant recurrences, escalating local therapies may have limited impact on overall prognosis.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31236813</pmid><doi>10.1007/s10549-019-05314-9</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7784-2826</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2019-09, Vol.177 (2), p.437-446 |
| issn | 0167-6806 1573-7217 |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adjuvant treatment Adult Aged Biomarkers, Tumor Breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - drug therapy Breast Neoplasms - etiology Cancer Cancer patients Cancer research Care and treatment Chemotherapy Chemotherapy, Adjuvant Clinical Decision-Making Clinical Trial Disease Management Female Humans Medical prognosis Medical research Medicine Medicine & Public Health Medicine, Experimental Metastases Metastasis Middle Aged Neoplasm Grading Neoplasm Recurrence, Local Neoplasm Staging Oncology Patients Prognosis Receptors, Estrogen - genetics Receptors, Estrogen - metabolism Regression analysis Risk Assessment Risk factors Surgery Survival Treatment Outcome |
| title | Locoregional risk assessment after neoadjuvant chemotherapy in patients with primary breast cancer: clinical utility of the CPS + EG score |
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