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Impact of endocrine therapy in early-stage breast cancer on time to locoregional recurrence.

2013· article· en· W2591241287 on OpenAlexaff
Ines B. Menjak, Ellen Maki, Hal K. Berman, Caroline Chung, David R. McCready, Srikala S. Sridhar

Bibliographic record

VenueJournal of Clinical Oncology · 2013
Typearticle
Languageen
FieldMedicine
TopicCancer Treatment and Pharmacology
Canadian institutionsPrincess Margaret Cancer CentreUniversity Health NetworkStatistics CanadaUniversity of Toronto
Fundersnot available
KeywordsMedicineBreast cancerLumpectomyTamoxifenCancerLymph nodeInternal medicineStage (stratigraphy)OncologyUnivariate analysisMedian follow-upGynecologySurgeryChemotherapyMastectomyMultivariate analysis

Abstract

fetched live from OpenAlex

64 Background: Locoregional recurrence (LR) remains a major source of morbidity and mortality in breast cancer. Our primary aim was to evaluate the impact of endocrine therapy (ET) on time to LR. Methods: A retrospective chart review of breast cancer patients (pts) treated with lumpectomy and locoregional radiation from 1999-2005 at the Princess Margaret Cancer Centre was carried out. LR was defined as ipsilateral breast or lymph node recurrence. Kaplan-Meier estimates of survival and univariate analyses were performed for age, menopausal status, tumor and nodal stage, grade, receptor status, adjuvant chemotherapy (AC) and ET. Results: Of 440 pts evaluated, the mean age at primary resection was 56 years (yrs) (range 40-79), and 67% were postmenopausal. The majority had ductal carcinomas (87%) and grade 1-2 (68%) tumors. Tumor distribution was 315 (72%) T1, 120 (27%) T2, 4 (1%) T3; 138 (31%) were node positive. Receptor status was ER/PR+HER2- 206 (47%), ER+PR+HER2unknown 80 (18%), ER-PR-HER2unknown 41 (9%), and triple negative 37 (8%). AC was used in 190 (43%). ET (tamoxifen and/or aromatase inhibitors) was initiated in 294 (84%) eligible pts, and 267/294 (91%) completed a minimum duration of ≥2 yrs. Overall, LR occurred in 24 (5%) pts, and 8/24 (33%) pts with LR also had distant metastases. Average time from surgery to LR was 5.4 yrs (range 8 months-12 yrs). The average duration of ET in pts with LR was 4.3 yrs (range 0-8), and 5.8 yrs (range 0-12) without LR. Of ER/PR+ pts with LR, 3/15 (20%) did not receive ET. At the time of LR, 5 (33%) pts were receiving ET. After stopping ET, 2 (13%) recurred 0-2 yrs, 3 (20%) at 4-5 yrs, and 2 (13%) at 7-8 yrs. Treatment with at least 2 yrs of ET predicted for fewer recurrences: at 2 yrs LR-free rate was 100% vs 90% for <2 yrs ET; at 5 yrs 99.6% vs 84%; and at 8 yrs 98.2% vs 84% (p=0.0092). ER/PR+HER2- pts had lower LR risk (p=0.028), and ER-/PR-/HER+ had higher LR risk (p=0.029). The remaining variables were not associated with risk of LRs. Survival post-LR was 90% (95%CI 64-97%) at 2 yrs and 65% (95%CI 34-84%) at 5 yrs. Conclusions: Pts who completed at least 2 yrs of ET had significantly lower risk of LR. The average time to LR was 5.4 years, and pts with LR had decreased survival at 5 yrs post-recurrence.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.004
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.005

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.004
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.135
GPT teacher head0.533
Teacher spread0.397 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2013
Admission routes1
Has abstractyes

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