Survival Outcomes in Women with Ipsilateral Breast Tumor Relapse: An Analysis of Cohorts Classified Clinically as 'True Recurrence' Versus 'New Primary'.
Notice bibliographique
Résumé
Abstract Background:Ipsilateral breast tumor relapse (IBTR) can occur in ∼5-20% of women after breast conserving therapy. Two entities of IBTR have been described: "True Recurrence" (TR), suggested to be cases of regrowth of pre-malignant or malignant cells not completely eradicated by surgery or radiation therapy; and "New Primary" (NP), distinct in histology and located away from the index tumor. Whether these two entities have different prognoses is unclear. This study examined a method of IBTR classification using chart review with pre-defined decision rules to assess histology and tumor location and compared survival between two groups classified as either TR or NP.Methods:Between 1989-1999, 6020 women with newly diagnosed invasive breast cancer, pT1-T2, 0-3 positive nodes, M0, treated with breast conserving surgery with clear margins were referred to the BC Cancer Agency. Of these, 289 cases had pathologically-confirmed IBTR, defined as the first recurrence occurring in the ipsilateral breast. Retrospective chart review was performed to abstract clinical data related to the index tumor and the IBTR. A set of decision rules established a priori (figure 1) was applied to classify these cases as either TR or NP.Time to recurrence, distant-relapse free survival (DRFS), and overall survival (OS) were compared between the two cohorts using Kaplan-Meier and log-rank statistics.Results:Of 289 subjects, 131(45%) were classified as TR, 128 (44%) as NP, and 30 (10%) unclassified due to insufficient information. The distributions of age at diagnosis, age at recurrence, index tumor histology, T size, nodal status, grade, lymphovascular invasion, and estrogen receptor status were similar in the two cohorts, (all p >0.05). The mean time to recurrence was shorter in TR compared to NP patients (4.7 years vs. 6.3 years, p=0.001). Surgical treatment of IBTR differed in the two groups, with 76% mastectomy and 21% local excision only in the TR cohort, compared to 81% mastectomy and 16% local excision only in the NP cohort (p<0.001). Systemic therapy at the time of IBTR also differed in the two groups, with hormone therapy alone used more frequently in the TR compared to the NP cohort (42% vs. 38%, p<0.001); and a smaller proportion of the NP cohort receiving both chemotherapy and hormone therapy compared to the TR cohort (8% vs. 15%, p<0.001). In the TR and NP cohorts, 10-year DRFS were 57% vs. 61%, p=0.59; and 10-year OS were 45% vs. 53%, p=0.67.Conclusions:The median time to recurrence is significantly longer in patients with IBTR classified as 'new primary' compared to 'true recurrence'. Non-statistically significant trends for more favorable DRFS and OS were observed for patients with NP compared to TR tumors. The hypothesis that NP and TR tumors are distinct entities with different survival prognoses requires confirmation with pathology review and molecular analyses. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4116.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».