Die Wirkung der adjuvanten Strahlentherapie auf das Letalitätsrisiko variiert je nach Tumorsitz bei Patientinnen mit einem nodal positiven Mammakarzinom

Translated title of the contribution: The Effect of adjuvant radiotherapy on mortality differs according to primary tumor location in women with node-positive breast cancer

Vincent Vinh-Hung, Pauline T. Truong, Wolfgang Janni, Nam Phong Nguyen, Georges Vlastos, G. Cserni, Melanie E. Royce, Wendy A. Woodward, Donald Promish, Patricia Tai, Guy Soete, Sabine Balmer-Majno, Bruno Cutuli, Guy Storme, Christine Bouchardy

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: To evaluate the prognostic significance of primary tumor location and to examine whether the effect of adjuvant radiotherapy on survival varies according to tumor location in women with axillary node-positive (ALN+) breast cancer (BC). Patients and Methods: Data were abstracted from the SEER database for 24,410 women aged 25-95 years, diagnosed between 1988-1997 with nonmetastatic T1-T2, ALN+ BC. Subgroup analyses were performed using interactions within proportional hazards models. Event was defined as death from any cause. Prognostic variables were selected using Akaike Information Criteria. Joint significances of subgroups were evaluated with Wald test. Results: Median follow-up was 10 years. In joint models, statistically significant interactions were found between tumor location, nodal involvement, type of surgery, and radiotherapy. Factorial presentation of interactions showed consistent 13% proportional reduction of mortality in all subgroups, except in women with medial tumors with > 4 ALN+ treated with mastectomy. In this subgroup, use of radiotherapy was associated with a 16% proportional increase in mortality. Conclusion: Medial tumor location is a significant adverse prognostic factor that should be considered in treatment decision- making for women with ALN+ BC. Improved survival was observed with radiotherapy use in all subgroups, except in women with medial tumors with > 4 ALN+ treated with postmastectomy radiotherapy. These findings raise concern that the favorable effect of radiotherapy may be offset by excess toxicities in the latter subgroup.

Original languageGerman
Pages (from-to)161-168
Number of pages8
JournalStrahlentherapie und Onkologie
Volume185
Issue number3
DOIs
Publication statusPublished - Mar 2009

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Adjuvant Radiotherapy
Breast Neoplasms
Radiotherapy
Mortality
Neoplasms
Joints
Survival
Mastectomy
Proportional Hazards Models
Cause of Death
Decision Making
Databases

Keywords

  • Breast cancer
  • Internal mammary nodes
  • Radiotherapy
  • Tumor location

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology

Cite this

Die Wirkung der adjuvanten Strahlentherapie auf das Letalitätsrisiko variiert je nach Tumorsitz bei Patientinnen mit einem nodal positiven Mammakarzinom. / Vinh-Hung, Vincent; Truong, Pauline T.; Janni, Wolfgang; Nguyen, Nam Phong; Vlastos, Georges; Cserni, G.; Royce, Melanie E.; Woodward, Wendy A.; Promish, Donald; Tai, Patricia; Soete, Guy; Balmer-Majno, Sabine; Cutuli, Bruno; Storme, Guy; Bouchardy, Christine.

In: Strahlentherapie und Onkologie, Vol. 185, No. 3, 03.2009, p. 161-168.

Research output: Contribution to journalArticle

Vinh-Hung, V, Truong, PT, Janni, W, Nguyen, NP, Vlastos, G, Cserni, G, Royce, ME, Woodward, WA, Promish, D, Tai, P, Soete, G, Balmer-Majno, S, Cutuli, B, Storme, G & Bouchardy, C 2009, 'Die Wirkung der adjuvanten Strahlentherapie auf das Letalitätsrisiko variiert je nach Tumorsitz bei Patientinnen mit einem nodal positiven Mammakarzinom', Strahlentherapie und Onkologie, vol. 185, no. 3, pp. 161-168. https://doi.org/10.1007/s00066-009-1921-z
Vinh-Hung, Vincent ; Truong, Pauline T. ; Janni, Wolfgang ; Nguyen, Nam Phong ; Vlastos, Georges ; Cserni, G. ; Royce, Melanie E. ; Woodward, Wendy A. ; Promish, Donald ; Tai, Patricia ; Soete, Guy ; Balmer-Majno, Sabine ; Cutuli, Bruno ; Storme, Guy ; Bouchardy, Christine. / Die Wirkung der adjuvanten Strahlentherapie auf das Letalitätsrisiko variiert je nach Tumorsitz bei Patientinnen mit einem nodal positiven Mammakarzinom. In: Strahlentherapie und Onkologie. 2009 ; Vol. 185, No. 3. pp. 161-168.
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abstract = "Purpose: To evaluate the prognostic significance of primary tumor location and to examine whether the effect of adjuvant radiotherapy on survival varies according to tumor location in women with axillary node-positive (ALN+) breast cancer (BC). Patients and Methods: Data were abstracted from the SEER database for 24,410 women aged 25-95 years, diagnosed between 1988-1997 with nonmetastatic T1-T2, ALN+ BC. Subgroup analyses were performed using interactions within proportional hazards models. Event was defined as death from any cause. Prognostic variables were selected using Akaike Information Criteria. Joint significances of subgroups were evaluated with Wald test. Results: Median follow-up was 10 years. In joint models, statistically significant interactions were found between tumor location, nodal involvement, type of surgery, and radiotherapy. Factorial presentation of interactions showed consistent 13{\%} proportional reduction of mortality in all subgroups, except in women with medial tumors with > 4 ALN+ treated with mastectomy. In this subgroup, use of radiotherapy was associated with a 16{\%} proportional increase in mortality. Conclusion: Medial tumor location is a significant adverse prognostic factor that should be considered in treatment decision- making for women with ALN+ BC. Improved survival was observed with radiotherapy use in all subgroups, except in women with medial tumors with > 4 ALN+ treated with postmastectomy radiotherapy. These findings raise concern that the favorable effect of radiotherapy may be offset by excess toxicities in the latter subgroup.",
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AU - Vinh-Hung, Vincent

AU - Truong, Pauline T.

AU - Janni, Wolfgang

AU - Nguyen, Nam Phong

AU - Vlastos, Georges

AU - Cserni, G.

AU - Royce, Melanie E.

AU - Woodward, Wendy A.

AU - Promish, Donald

AU - Tai, Patricia

AU - Soete, Guy

AU - Balmer-Majno, Sabine

AU - Cutuli, Bruno

AU - Storme, Guy

AU - Bouchardy, Christine

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N2 - Purpose: To evaluate the prognostic significance of primary tumor location and to examine whether the effect of adjuvant radiotherapy on survival varies according to tumor location in women with axillary node-positive (ALN+) breast cancer (BC). Patients and Methods: Data were abstracted from the SEER database for 24,410 women aged 25-95 years, diagnosed between 1988-1997 with nonmetastatic T1-T2, ALN+ BC. Subgroup analyses were performed using interactions within proportional hazards models. Event was defined as death from any cause. Prognostic variables were selected using Akaike Information Criteria. Joint significances of subgroups were evaluated with Wald test. Results: Median follow-up was 10 years. In joint models, statistically significant interactions were found between tumor location, nodal involvement, type of surgery, and radiotherapy. Factorial presentation of interactions showed consistent 13% proportional reduction of mortality in all subgroups, except in women with medial tumors with > 4 ALN+ treated with mastectomy. In this subgroup, use of radiotherapy was associated with a 16% proportional increase in mortality. Conclusion: Medial tumor location is a significant adverse prognostic factor that should be considered in treatment decision- making for women with ALN+ BC. Improved survival was observed with radiotherapy use in all subgroups, except in women with medial tumors with > 4 ALN+ treated with postmastectomy radiotherapy. These findings raise concern that the favorable effect of radiotherapy may be offset by excess toxicities in the latter subgroup.

AB - Purpose: To evaluate the prognostic significance of primary tumor location and to examine whether the effect of adjuvant radiotherapy on survival varies according to tumor location in women with axillary node-positive (ALN+) breast cancer (BC). Patients and Methods: Data were abstracted from the SEER database for 24,410 women aged 25-95 years, diagnosed between 1988-1997 with nonmetastatic T1-T2, ALN+ BC. Subgroup analyses were performed using interactions within proportional hazards models. Event was defined as death from any cause. Prognostic variables were selected using Akaike Information Criteria. Joint significances of subgroups were evaluated with Wald test. Results: Median follow-up was 10 years. In joint models, statistically significant interactions were found between tumor location, nodal involvement, type of surgery, and radiotherapy. Factorial presentation of interactions showed consistent 13% proportional reduction of mortality in all subgroups, except in women with medial tumors with > 4 ALN+ treated with mastectomy. In this subgroup, use of radiotherapy was associated with a 16% proportional increase in mortality. Conclusion: Medial tumor location is a significant adverse prognostic factor that should be considered in treatment decision- making for women with ALN+ BC. Improved survival was observed with radiotherapy use in all subgroups, except in women with medial tumors with > 4 ALN+ treated with postmastectomy radiotherapy. These findings raise concern that the favorable effect of radiotherapy may be offset by excess toxicities in the latter subgroup.

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KW - Internal mammary nodes

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