In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. 528-528
Abstract:
528 Background: Better tools are needed to estimate the risk of local recurrence (LR; DCIS or invasive) after breast-conserving surgery (BCS) for DCIS to inform treatment decisions. The DCIS Score (DS) was validated as a predictor of LR in E5194 and Ontario DCIS Cohort (ODC) after BCS without radiation (Solin,2013; Rakovitch,2015). We performed a meta-analysis (MA) combining data from E5194 and ODC with additional follow-up from E5194 adjusting for pertinent clinico-pathologic factors to provide refined prediction estimates of LR risk after BCS alone. Methods: The MA used data from E5194 and ODC. Patients with positive margins and multifocality were excluded. Identical Cox regression models were fit including age at diagnosis ( 〈 50, ≥50 yr), tumor size (1cm, 〉 1cm), DCIS Score and year of surgery (before vs after 2000). Grade was not significant. MA was used to calculate precision-weighted estimates of 10 year LR risk by DS. Results: Combined cohort includes 773 pts (tamoxifen used in 20% E5194, 17% of ODC 〉 65 yr). The DS and the clinico-pathologic variables age, tumor size and year provided independent prognostic information on 10 yr LR risk (p≤.009). Hazard ratios from E5194 and ODC cohorts were similar for tumor size ≤1 vs. 〉 1cm (1.45, 1.47), age ≥50 vs. 〈 50 yr (0.61, 0.84) and surgery year after 2000 (0.67, 0.49). 10 yr LR risks by combinations of age, tumor size, and DS are detailed in Table. For patients ≥50 yr with tumors ≤1cm and low risk DS, the 10 yr LR risks range from 5.3-10.0%. A high risk DS is associated with a higher 10 yr predicted risk of LR in all subsets. 10 yr risk of contralateral BC was 5.4%. Conclusions: This MA provides refined estimates of 10 yr LR risk after BCS alone for DCIS. Adding clinico-pathologic factors to the DCIS Score provides enhanced prognostic LR risk estimates to guide individualized treatment decision-making. [Table: see text]
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.15_suppl.528
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
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