Abstract
Background
American Joint Committee on Cancer (AJCC) 8th Edition Breast Cancer Staging System, biological information in addition to anatomical information was added as a basis for prognosis evaluation, but its prognostic impact in Japanese patients treated with postoperative radiotherapy has not been discussed. To determine the applicability of the updated prognostic staging system, we evaluated the prognostic value and confirmed the effectiveness of this system in patients in whom postoperative radiotherapy was performed.
Materials and methods
Patients who were treated with postoperative radiotherapy for breast cancer in our institution between January 2011 and December 2015 were restaged by the AJCC 8th pathological prognosis staging system, and then overall survival (OS), disease-free survival (DFS) rates and hazard ratios (HR) were analyzed to compare the predictive fit of the two staging systems.
Results
Five hundred and seven patients who in whom postoperative radiotherapy was performed for breast cancer were enrolled in this study. 36.1% patients were downstaged and 5.3% patients were upstaged from the 7th to 8th editions staging system classification. Kaplan–Meier curves and HRs showed differences in OS and DFS rates between the 7th edition and 8th edition staging systems. The AJCC 8th edition prognostic stage system has a better prognostic prediction of OS and DFS than does the 7th edition anatomic stage system.
Conclusions
Compared with the 7th edition in breast cancer, AJCC 8th edition prognostic stage system has more precise stratification and superior prognostic value, providing a more accurate reference for the choice of radiotherapy for patients with breast cancer.
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References
Siegel RL, Miller KD (2017) Jemal A (2017) Cancer Statistics. CA Cancer J Clin 67(1):7–30. https://doi.org/10.3322/caac.21387
Duffy MJ, Harbeck N, Nap M et al (2017) Clinical use of biomarkers in breast cancer: Updated guidelines from the European Group on Tumor Markers (EGTM). Eur J Cancer 75:284–298. https://doi.org/10.1016/j.ejca.2017.01.017
Cancer staging manual: updated breast chapter for 8th edition. American Joint Committee on Cancer.https://cancerstaging.org/references-tools/deskreferences/Pages/Breast-Cancer-Staging.aspx. Accessed July 1st, 2017
Kim I, Choi HJ, Ryu JM et al (2018) Prognostic Validation of the American Joint Committee on Cancer 8th Staging System in 24,014 Korean Patients with Breast Cancer. J Breast Cancer 21(2):173–181. https://doi.org/10.4048/jbc.2018.21.2.173
Kantor O, Bao J, Jaskowiak N et al (2019) The prognostic value of the AJCC 8th edition staging system for patients undergoing neoadjuvant chemotherapy for breast cancer. Ann Surg Oncol. https://doi.org/10.1245/s10434-019-07636-w
Xu L, Li JH, Ye JM et al (2017) A retrospective survival analysis of anatomic and prognostic stage group based on the American joint committee on cancer 8th edition cancer staging manual in luminal human epidermal growth factor receptor - negative breast cancer. Chin Med J 130(16):1945–1952. 10.4103/0366-6999.211896
Kurundkar A, Gao X, Zhang K et al (2018) Comparison of AJCC Anatomic and Clinical Prognostic Stage Groups in Breast Cancer: Analysis of 3322 Cases From a Single Institution. Clin Breast Cancer 18(6):e1347–e1352. https://doi.org/10.1016/j.clbc.2018.07.013
Clarke M, Collins R, Darby S et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366(9503):2087–2106. https://doi.org/10.1016/S0140-6736(05)67887-7
Early Breast Cancer Trialists' Collaborative G, Darby S, McGale P, Correa C et al (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378 (9804):1707–1716. 10.1016/S0140-6736(11)61629-2
Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347(16):1233–1241. https://doi.org/10.1056/NEJMoa022152
Weiss A, Chavez-MacGregor M, Lichtensztajn DY et al (2018) Validation Study of the American Joint Committee on Cancer Eighth Edition Prognostic Stage Compared With the Anatomic Stage in Breast Cancer. JAMA Oncol 4 (2):203–209. 10.1001/jamaoncol.2017.4298
De Abreu FB, Schwartz GN, Wells WA et al (2014) Personalized therapy for breast cancer. Clin Genet 86(1):62–67. https://doi.org/10.1111/cge.12381
Harris LN, Ismaila N, McShane LM et al (2016) Use of biomarkers to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer: American Society of clinical oncology clinical practice guideline summary. J Oncol Pract 12(4):384–389. https://doi.org/10.1200/JOP.2016.010868
Park S, Koo JS, Kim MS et al (2012) Characteristics and outcomes according to molecular subtypes of breast cancer as classified by a panel of four biomarkers using immunohistochemistry. Breast 21:50–57. https://doi.org/10.1016/j.breast.2011.07.008
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Tang, L., Ishikawa, Y., Matsushita, H. et al. Prognostic value of the AJCC 8th edition staging system for Japanese patients treated with surgery followed by radiotherapy for breast cancer. Int J Clin Oncol 25, 1499–1505 (2020). https://doi.org/10.1007/s10147-020-01686-x
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DOI: https://doi.org/10.1007/s10147-020-01686-x