304P - Prognostic factors after neoadjuvant chemotherapy in breast cancer: Surgery type as a new prognostic factor

Date 10 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Surgical oncology
Breast Cancer
Therapy
Radiation oncology
Presenter MiWA Fujihara
Citation Annals of Oncology (2016) 27 (6): 68-99. 10.1093/annonc/mdw365
Authors M. Fujihara, T. Kin, Y. Yoshimura, Y. Kajiwara, M. Ito, K. Abe, Y. Sakata, K. Hiraki, S. Ohtani
  • Naka-ku, Hiroshima City Hospital, 730-8518 - Hiroshima/JP

Abstract

Background

Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) is not necessarily linked to long-term survival. Response to chemotherapy and outcomes after NAC differ among breast cancer subtypes, so we analyzed prognostic factors by subtype.

Methods

We retrospectively analyzed 451 patients treated with anthracycline and taxane-based NAC between 2007 and 2015. Trastuzumab was added for human epidermal growth factor receptor (HER)-2-positive breast cancer. pCR was defined as no residual invasive breast carcinoma; noninvasive residuals and infiltrated lymph nodes were allowed. Kaplan–Meier and multivariate cox regression analyses were used to evaluate disease-free interval (DFI) and DFI prognostic values, respectively.

Results

Median follow-up was 43 months; median age was 56 (range, 23–88) years. pCR rate was 26.2% (118/451) in all cases: 0% (0/82), luminal A; 10.9% (14/128), luminal B HER2(−); 43.1% (31/71), luminal B HER2(+); 59.4% (38/64), HER2; and 34% (36/106), triple negative (TN). For all subtypes, patients who achieved pCR had a non-significantly higher DFI. Multivariate cox regression showed these associations with DFI: surgery type and Ki-67 > 30% after NAC for all cases and luminal B HER2(-); ypN (lymph node status after NAC), luminal B HER2(+); ypN and menopausal status, HER2; and age, surgery type, and clinical lymph node status, TN. Kaplan–Meier analysis showed that surgery type was strongly associated with DFI after NAC. Mastectomy patients had significantly poorer prognosis than partial mastectomy patients for all subtypes except HER2. For all cases, the median DFI in mastectomy patients was 73 months, but DFI was not reached in partial mastectomy patients (p 

Conclusions

Prognostic factors after NAC differ among subtypes. Surgery type was strongly associated with outcomes after NAC, so it could be an independent prognostic factor.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

Hiroshima City Hiroshima Citizens Hospital

Disclosure

All authors have declared no conflicts of interest.