Evidence map›Paper›PMID 36611067›Full record

ArticleAnnals of surgical oncology2023

Survival Benefit of Chemotherapy According to 21-Gene Recurrence Score in Young Women with Breast Cancer.

A L Nash, Y Ren, J K Plichta, L H Rosenberger, A M B van den Bruele, M L DiNome, K Westbrook, E Shelley Hwang

Abstract read
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Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

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

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
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

8 authors.

A L NashDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
Y RenDuke Cancer Institute Biostatistics Shared Resources, Durham, NC, USA.
J K PlichtaDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
L H RosenbergerDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
A M B van den BrueleDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
M L DiNomeDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
K WestbrookDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
E Shelley HwangDepartment of Surgery, Duke University Medical Center, Durham, NC, USA. shelley.hwang@duke.edu.ORCID http://orcid.org/0000-0002-8571-1148

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInitial trials evaluating Oncotype DX, reported as a recurrence score (RS) from 0 to 100, were not powered to evaluate overall survival, and premenopausal women were underrepresented. The purpose of this study was to explore the benefit of chemotherapy according to RS among younger women eligible for oncotype testing.

methodsWomen aged 40-50, diagnosed with HR-positive, HER2-negative breast cancer between 2010 and 2017 were selected from the National Cancer Database (NCBD). Patients were grouped by age, RS, nodal status, and chemotherapy receipt. Kaplan-Meier curves were used to compare unadjusted overall survival (OS) between the groups, and log-rank tests were used to test for a difference between groups. Cox proportional hazards models were used to examine the association between select factors and OS.

resultsA total of 15,422 patients met inclusion criteria, 45.3% of whom received chemotherapy. Median follow-up time was 66.4 (50.6-86.6) months. Patients who received chemotherapy were more likely to have higher-stage and higher-grade tumors, tumors that were PR-negative, and have higher RS (p < 0.001 for all). RS was prognostic for OS regardless of nodal status. After adjustment, chemotherapy was associated with a significant improvement in OS only in the pN1 RS 31-50 subgroup (p = 0.02).

conclusionsRS retains its prognostic value in younger patients with early stage HR-positive, HER2-negative breast cancer. Chemotherapy survival benefit was limited to patients aged 40-50 with pN1 disease and RS of 31-50. Therefore, chemotherapy decision-making should be especially preference-sensitive in women aged 40-50 with intermediate RS, where it may not provide a survival benefit for many women.

Indexed as

Breast NeoplasmsBiomarkers, TumorChemotherapy, AdjuvantFemaleHumansNeoplasm Recurrence, LocalPrognosisProportional Hazards ModelsReceptors, EstrogenBiomarkers, TumorReceptors, Estrogen

Identifiers

PMID36611067

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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.