Evidence map›Paper›PMID 39146842›Full record

ArticleThe Journal of surgical research2024

Assessment of Treatment Sequence in Patients With Stage III Breast Cancer.

Koumani W Ntowe, Samantha M Thomas, Juliet C Dalton, Akiko Chiba, Hannah E Woriax, Gayle DiLalla, Maggie L DiNome, Jennifer K Plichta

Abstract read
In one paragraph

Article in The Journal of surgical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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.

Koumani W NtoweDepartment of Surgery, Duke University Medical Center, Durham, North Carolina.
Samantha M ThomasDuke Cancer Institute, Duke University, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina.
Juliet C DaltonDepartment of Surgery, Duke University Medical Center, Durham, North Carolina.
Akiko ChibaDepartment of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Duke University, Durham, North Carolina.
Hannah E WoriaxDepartment of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Duke University, Durham, North Carolina.
Gayle DiLallaDepartment of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Duke University, Durham, North Carolina.
Maggie L DiNomeDepartment of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Duke University, Durham, North Carolina.
Jennifer K PlichtaDepartment of Surgery, Duke University Medical Center, Durham, North Carolina; Duke Cancer Institute, Duke University, Durham, North Carolina; Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina. Electronic address: jennifer.plichta@duke.edu.

Funding

Women's Cancer Research ProgramP30CA014236 · NCI · DUKE UNIVERSITY · PI JOHN N. NORTON · 1985 to 2026
$174.8M
Building Interdisciplinary Research Careers in Women's Health (K12) - Administrative SupplementK12AR084231 · NIAMS · DUKE UNIVERSITY · PI Cindy Amundsen · 2023 to 2026
$2.5M
NCI NIH HHS P30 CA014236NIAMS NIH HHS K12 AR084231
6 · The paper itself

Abstract

introductionStage III breast cancer is defined as locally advanced breast cancer and is treated with curative intent. Historically, overall survival (OS) did not differ based on treatment sequence (neoadjuvant chemotherapy [NAC] followed by surgery versus surgery followed by chemotherapy). Given recent advancements, we examined if treatment sequence may be associated with improved OS in a contemporary cohort of patients with stage III breast cancer.

methodsPatients aged 18-80 years with prognostic stage III breast cancer who received chemotherapy and surgery were selected from the Surveillance, Epidemiology, and End Results database. Patients were stratified by treatment sequence (NAC versus surgery first). Unadjusted OS and breast cancer-specific survival (BCSS) were estimated using the Kaplan-Meier method and compared with log-rank tests. Cox proportional hazards models were used to estimate the association of treatment sequence with OS and BCSS after adjustment for selected covariates.

resultsThe study included 26,573 patients; median follow-up was 62.0 months (95% confidence interval [CI] 61.0-63.0). Patients receiving NAC had a worse OS and BCSS compared to those who underwent surgery first (5-year OS rates 0.66 versus 0.73; 5-year BCSS rates 0.70 versus 0.77; both log-rank P < 0.001). After adjustment for tumor subtype, receipt of NAC (versus surgery first) remained associated with a worse OS (hazard ratio 1.27, 95% CI 1.2-1.34, P < 0.001) and BCSS (hazard ratio 1.35, 95% CI 1.27-1.43, P < 0.001).

conclusionsBased on data from patients treated largely before 2020, undergoing surgery first may be associated with improved survival, even after adjustment for known covariates including tumor subtype. These findings may inform treatment when caring for patients with operable, locally advanced breast cancer.

Indexed as

Breast NeoplasmsNeoadjuvant TherapyNeoplasm StagingSEER ProgramAdolescentAdultAgedAged, 80 and overChemotherapy, AdjuvantFemaleHumansKaplan-Meier EstimateMastectomyMiddle AgedRetrospective StudiesYoung AdultBreast surgeryChemotherapyLocally advanced breast cancerSurvivalTreatment sequence

Identifiers

PMID39146842
PMCPMC11490391

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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.