Survival Analysis of Patients with Breast Cancer Undergoing a Modified Radical Mastectomy With or Without a Thoracic Paravertebral Block: a 5-Year Follow-up of a Randomized Controlled Trial
Bibliographic record
Abstract
AIM: This 5-year prospective follow-up of women randomized to general anesthesia (GA) with or without a thoracic paravertebral block (TPVB) examined the risk of local recurrence, metastasis and mortality after breast cancer surgery. PATIENTS AND METHODS: A total of 180 patients undergoing modified radical mastectomy were randomized to one of three study groups: standardized GA only; GA with a single-injection TPVB (s-TPVB) and placebo paravertebral infusion after surgery for 72-h; and GA plus with continuous TPVB (c-TPVB) for 72-h postoperatively. Cox proportional models were used to assess the effect of TPVB on long-term outcomes. Equivalence testing was used to help interpret the results. RESULTS: The incidence [95% confidence interval (CI)] of cancer recurrence, metastatic spread and all-cause mortality was 2.3% (0.7-5.4%), 7.9% (4.6-12.6%) and 6.8% (3.6-11.2%), respectively. Four women had cancer recurrence and had metastatic spread. Compared to the GA-only group, the risk of metastatic spread was not different from that of GA with s-TPVB [hazard ratio (HR)=1.11, 95% CI=0.32-3.83) nor from that with GA plus c-TPVB (HR=0.79, 95% CI=0.21-2.96) (p=0.88). Compared to the GA-only group, the risk of mortality was similarly not different from that of the two other groups (HR=2.57, 95% CI=0.66-9.92; and HR=0.66, 95% CI=0.11-3.97, respectively, p=0.15). CONCLUSION: Although the original study was underpowered to properly address long-term outcomes, the results of this analysis suggest that TPVB, administered whether as a single-injection or continuous infusion during the perioperative period, had little to no appreciable effect on local recurrence, metastasis or mortality after breast cancer surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot 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.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.005 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".