TY - JOUR
T1 - Conditional regional recurrence risk
T2 - The effect of event-free years in different subtypes of breast cancer
AU - Vane, Marissa L. G.
AU - Moossdorff, Martine
AU - van Maaren, Marissa C.
AU - van Kuijk, Sander M. J.
AU - van Nijnatten, Thiemo J. A.
AU - van Roozendaal, Lori M.
AU - Boerma, Evert-Jan G.
AU - de WIlt, Johannes H. W.
AU - Smidt, Marjolein L.
N1 - Publisher Copyright:
© 2020
PY - 2021/6
Y1 - 2021/6
N2 - Background: Regional recurrence (RR), also known as lymph node recurrence, is an endpoint in several trials concerning reducing axillary treatment in cT1-2N0 breast cancer patients. The risk of RR may decrease with each subsequent event-free year, affecting the yield and consequently usefulness of long (er) follow-up. The aim of this study is to determine the risk of RR as a first event within five years after diagnosis in subtypes of breast cancer, conditional to being event-free for one, two, three and four years.Methods: From the Netherlands Cancer Registry, cT1-2N0 breast cancer patients diagnosed from 2005 to 2008 were analyzed. Subgroup analysis was performed for pT1-2N+(sn) patients. RR risk was calculated with Kaplan-Meier analysis. Conditional RR (assuming x event-free years) was determined by selecting patients without an event at x years, and calculating the remaining risk for RR within five years after diagnosis.Results: A total of 18,009 cT1-2N0 (all pN stages) breast cancer patients were included. RR occurred in 1.3% of cT1-2N0 and 1.5% of pT1-2N+(sn) patients. The risk of RR varied between subtypes; it was highest for triple negative tumors and lowest for ER + PR + Her2-and ER + Her2+ tumors. After event-free years, the risk of RR decreased subsequently in both groups and in all subtypes. After two event-free years, the risk of RR was 0.8%.Conclusion: The absolute yield of follow-up to detect RR beyond two years is low; for every 125 event-free patients, one RR can be expected until five years. This suggests that follow-up longer than two years is of limited value for detecting RR in both clinical and research setting.(c) 2020 Published by Elsevier Ltd.
AB - Background: Regional recurrence (RR), also known as lymph node recurrence, is an endpoint in several trials concerning reducing axillary treatment in cT1-2N0 breast cancer patients. The risk of RR may decrease with each subsequent event-free year, affecting the yield and consequently usefulness of long (er) follow-up. The aim of this study is to determine the risk of RR as a first event within five years after diagnosis in subtypes of breast cancer, conditional to being event-free for one, two, three and four years.Methods: From the Netherlands Cancer Registry, cT1-2N0 breast cancer patients diagnosed from 2005 to 2008 were analyzed. Subgroup analysis was performed for pT1-2N+(sn) patients. RR risk was calculated with Kaplan-Meier analysis. Conditional RR (assuming x event-free years) was determined by selecting patients without an event at x years, and calculating the remaining risk for RR within five years after diagnosis.Results: A total of 18,009 cT1-2N0 (all pN stages) breast cancer patients were included. RR occurred in 1.3% of cT1-2N0 and 1.5% of pT1-2N+(sn) patients. The risk of RR varied between subtypes; it was highest for triple negative tumors and lowest for ER + PR + Her2-and ER + Her2+ tumors. After event-free years, the risk of RR decreased subsequently in both groups and in all subtypes. After two event-free years, the risk of RR was 0.8%.Conclusion: The absolute yield of follow-up to detect RR beyond two years is low; for every 125 event-free patients, one RR can be expected until five years. This suggests that follow-up longer than two years is of limited value for detecting RR in both clinical and research setting.(c) 2020 Published by Elsevier Ltd.
KW - Breast cancer
KW - Conditional survival
KW - Regional recurrence
KW - Subtypes of breast cancer
KW - NO AXILLARY DISSECTION
KW - SURVIVAL
KW - WOMEN
U2 - 10.1016/j.ejso.2020.11.122
DO - 10.1016/j.ejso.2020.11.122
M3 - Article
C2 - 33349525
SN - 0748-7983
VL - 47
SP - 1292
EP - 1298
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 6
ER -