Evidence map›Paper›PMID 27663567›Full record

Trial reportAnnals of surgical oncology2017

Poor Prognosis After Second Locoregional Recurrences in the CALOR Trial.

Irene L Wapnir, Shari Gelber, Stewart J Anderson, Eleftherios P Mamounas, André Robidoux, Miguel Martín, Johan W R Nortier, Charles E Geyer, Alexander H G Paterson, István Láng and 8 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of surgical oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Efficacy of Chemotherapy for ER-Negative and ER-Positive Isolated Locoregional Recurrence of Breast Cancer: Final Analysis of the CALOR Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Irene L WapnirNRG Oncology, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA. wapnir@stanford.edu.
Shari GelberIBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, and Frontier Science and Technology Research Foundation, Boston, MA, USA.
Stewart J AndersonNRG Oncology and Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
Eleftherios P MamounasNRG Oncology and University of Florida Health Cancer Center at Orlando Health, Orlando, FL, USA.
André RobidouxNRG Oncology and Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada.
Miguel MartínGEICAM, Instituto de Investigacion SanitariaGregorio Marañon, Universidad Complutense, Madrid, Spain.
Johan W R NortierBOOG, Dutch Breast Cancer Trialists' Group, Leids Universitair Medisch Centrum, Leiden, Netherlands.
Charles E GeyerNRG Oncology and Virginia Commonwealth University Massey Cancer Center, Richmond, VA, USA.
Alexander H G PatersonNRG Oncology and Tom Baker Cancer Centre, Calgary, Alberta, Canada.
István LángIBCSG and National Institute of Oncology, Budapest, Hungary.
Karen N PriceIBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, and Frontier Science and Technology Research Foundation, Boston, MA, USA.
Alan S CoatesIBCSG, Bern, Switzerland and University of Sydney, Sydney, Australia.
Richard D GelberIBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard TH Chan School of Public Health, Harvard Medical School, and Frontier Science and Technology Research Foundation, Boston, MA, USA.
Priya RastogiNRG Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
Meredith M ReganIBCSG Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Norman WolmarkNRG Oncology and the Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA.
Stefan AebiIBCSG, Luzerner Kantonsspital, Lucerne and University of Berne, Switzerland and Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland.
CALOR trial investigators

Funding

NRG Oncology Network Group Operations Center - GY9 BIQSFP Reports/BudgetsU10CA180868 · NCI · NRG ONCOLOGY FOUNDATION, INC. · PI NORMAN WOLMARK · 2014 to 2026
$206.8M
Statistics CoreU10CA180822 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI James J. Dignam, GREG YOTHERS · 2014 to 2026
$146.4M
NRG Oncology NCORP Research Base-BIQSFPUG1CA189867 · NCI · NRG ONCOLOGY FOUNDATION, INC. · PI Deborah Watkins Bruner, Lisa A. Kachnic · 2014 to 2026
$140.5M
NCI NIH HHS U10 CA180822NCI NIH HHS U10 CA180868NCI NIH HHS UG1 CA189867
6 · The paper itself

Abstract

backgroundIsolated locoregional recurrences (ILRRs) of breast cancer confer a significant risk for the development of distant metastasis. Management practices and second ILRR events in the Chemotherapy as Adjuvant for LOcally Recurrent breast cancer (CALOR) trial were investigated.

methodsIn this study, 162 patients with ILRR were randomly assigned to receive postoperative chemotherapy or no chemotherapy. Descriptive statistics characterize outcomes according to local therapy and the influence of hormone receptor status on subsequent recurrences. Competing risk regression models, Kaplan-Meier estimates, and Cox proportional hazards models were used to evaluate associations between treatment, site of second recurrence, and outcome.

resultsThe median follow-up period was 4.9 years. Of the 98 patients who received breast-conserving primary surgery 89 had an ipsilateral-breast tumor recurrence. Salvage mastectomy was performed for 73 patients and repeat lumpectomy for 16 patients. Another eight patients had nodal ILRR, and one patient had chest wall ILRR. Among 64 patients whose primary surgery was mastectomy, 52 had chest wall/skin ILRR, and 12 had nodal ILRR. For 15 patients, a second ILRR developed a median of 1.6 years (range 0.08-4.8 years) after ILRR. All second ILRRs occurred for patients with progesterone receptor-negative ILRR. Death occurred for 7 (47 %) of 15 patients with a second ILRR and 19 (51 %) of 37 patients with a distant recurrence. As shown in the multivariable analysis, the significant predictors of survival after either a second ILRR or distant recurrence were chemotherapy for the primary cancer (hazard ratio [HR], 3.55; 95 % confidence interval [CI], 1.15-10.9; p = 0.03) and the interval (continuous) from the primary surgery (HR, 0.87; 95 % CI, 0.75-1.00; p = 0.05).

conclusionsSecond ILRRs represented about one third of all recurrence events after ILRR, and all were PR-negative. These second ILRRs and distant metastases portend an unfavorable outcome.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsFemaleFollow-Up StudiesHumansMastectomyMastectomy, SegmentalNeoplasm Recurrence, LocalPrognosisProspective StudiesSurvival Rate

Identifiers

PMID27663567
PMCPMC5215961

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.