A prognostic scoring model for survival after locoregional therapy in de novo stage IV breast cancer

Anuhya Kommalapati, Sri Harsha Tella, Gaurav Goyal, Apar Kishor P Ganti, Jairam Krishnamurthy, Pavan Kumar Tandra

Research output: Contribution to journalArticle

Abstract

Background: The role of locoregional treatment (LRT) remains controversial in de novo stage IV breast cancer (BC). We sought to analyze the role of LRT and prognostic factors of overall survival (OS) in de novo stage IV BC patients treated with LRT utilizing the National Cancer Data Base (NCDB). The objective of the current study is to create and internally validate a prognostic scoring model to predict the long-term OS for de novo stage IV BC patients treated with LRT. Methods: We included de novo stage IV BC patients reported to NCDB between 2004 and 2015. Patients were divided into LRT and no-LRT subsets. We randomized LRT subset to training and validation cohorts. In the training cohort, a seventeen-point prognostic scoring system was developed based on the hazard ratios calculated using Cox-proportional method. We stratified both training and validation cohorts into two “groups” [group 1 (0–7 points) and group 2 (7–17 points)]. Kaplan–Meier method and log-rank test were used to compare OS between the two groups. Our prognostic score was validated internally by comparing the OS between the respective groups in both the training and validation cohorts. Results: Among 67,978 patients, LRT subset (21,200) had better median OS as compared to that of no-LRT (45 vs. 24 months; p < 0.0001). The group 1 and group 2 in the training cohort showed a significant difference in the 3-year OS (p < 0.0001) (68 vs. 26%). On internal validation, comparable OS was seen between the respective groups in each cohort (p = 0.77). Conclusions: Our prognostic scoring system will help oncologists to predict the prognosis in de novo stage IV BC patients treated with LRT. Although firm treatment-related conclusions cannot be made due to the retrospective nature of the study, LRT appears to be associated with a better OS in specific subgroups.

Original languageEnglish (US)
Pages (from-to)677-685
Number of pages9
JournalBreast Cancer Research and Treatment
Volume170
Issue number3
DOIs
StatePublished - Aug 1 2018

Fingerprint

Breast Neoplasms
Survival
Therapeutics
Databases
Neoplasms
Retrospective Studies

Keywords

  • Locoregional therapy
  • Prediction model
  • Stage IV breast cancer
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A prognostic scoring model for survival after locoregional therapy in de novo stage IV breast cancer. / Kommalapati, Anuhya; Tella, Sri Harsha; Goyal, Gaurav; Ganti, Apar Kishor P; Krishnamurthy, Jairam; Tandra, Pavan Kumar.

In: Breast Cancer Research and Treatment, Vol. 170, No. 3, 01.08.2018, p. 677-685.

Research output: Contribution to journalArticle

Kommalapati, Anuhya ; Tella, Sri Harsha ; Goyal, Gaurav ; Ganti, Apar Kishor P ; Krishnamurthy, Jairam ; Tandra, Pavan Kumar. / A prognostic scoring model for survival after locoregional therapy in de novo stage IV breast cancer. In: Breast Cancer Research and Treatment. 2018 ; Vol. 170, No. 3. pp. 677-685.
@article{fbb46716e0d34b249eba36abf4401271,
title = "A prognostic scoring model for survival after locoregional therapy in de novo stage IV breast cancer",
abstract = "Background: The role of locoregional treatment (LRT) remains controversial in de novo stage IV breast cancer (BC). We sought to analyze the role of LRT and prognostic factors of overall survival (OS) in de novo stage IV BC patients treated with LRT utilizing the National Cancer Data Base (NCDB). The objective of the current study is to create and internally validate a prognostic scoring model to predict the long-term OS for de novo stage IV BC patients treated with LRT. Methods: We included de novo stage IV BC patients reported to NCDB between 2004 and 2015. Patients were divided into LRT and no-LRT subsets. We randomized LRT subset to training and validation cohorts. In the training cohort, a seventeen-point prognostic scoring system was developed based on the hazard ratios calculated using Cox-proportional method. We stratified both training and validation cohorts into two “groups” [group 1 (0–7 points) and group 2 (7–17 points)]. Kaplan–Meier method and log-rank test were used to compare OS between the two groups. Our prognostic score was validated internally by comparing the OS between the respective groups in both the training and validation cohorts. Results: Among 67,978 patients, LRT subset (21,200) had better median OS as compared to that of no-LRT (45 vs. 24 months; p < 0.0001). The group 1 and group 2 in the training cohort showed a significant difference in the 3-year OS (p < 0.0001) (68 vs. 26{\%}). On internal validation, comparable OS was seen between the respective groups in each cohort (p = 0.77). Conclusions: Our prognostic scoring system will help oncologists to predict the prognosis in de novo stage IV BC patients treated with LRT. Although firm treatment-related conclusions cannot be made due to the retrospective nature of the study, LRT appears to be associated with a better OS in specific subgroups.",
keywords = "Locoregional therapy, Prediction model, Stage IV breast cancer, Survival",
author = "Anuhya Kommalapati and Tella, {Sri Harsha} and Gaurav Goyal and Ganti, {Apar Kishor P} and Jairam Krishnamurthy and Tandra, {Pavan Kumar}",
year = "2018",
month = "8",
day = "1",
doi = "10.1007/s10549-018-4802-2",
language = "English (US)",
volume = "170",
pages = "677--685",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - A prognostic scoring model for survival after locoregional therapy in de novo stage IV breast cancer

AU - Kommalapati, Anuhya

AU - Tella, Sri Harsha

AU - Goyal, Gaurav

AU - Ganti, Apar Kishor P

AU - Krishnamurthy, Jairam

AU - Tandra, Pavan Kumar

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Background: The role of locoregional treatment (LRT) remains controversial in de novo stage IV breast cancer (BC). We sought to analyze the role of LRT and prognostic factors of overall survival (OS) in de novo stage IV BC patients treated with LRT utilizing the National Cancer Data Base (NCDB). The objective of the current study is to create and internally validate a prognostic scoring model to predict the long-term OS for de novo stage IV BC patients treated with LRT. Methods: We included de novo stage IV BC patients reported to NCDB between 2004 and 2015. Patients were divided into LRT and no-LRT subsets. We randomized LRT subset to training and validation cohorts. In the training cohort, a seventeen-point prognostic scoring system was developed based on the hazard ratios calculated using Cox-proportional method. We stratified both training and validation cohorts into two “groups” [group 1 (0–7 points) and group 2 (7–17 points)]. Kaplan–Meier method and log-rank test were used to compare OS between the two groups. Our prognostic score was validated internally by comparing the OS between the respective groups in both the training and validation cohorts. Results: Among 67,978 patients, LRT subset (21,200) had better median OS as compared to that of no-LRT (45 vs. 24 months; p < 0.0001). The group 1 and group 2 in the training cohort showed a significant difference in the 3-year OS (p < 0.0001) (68 vs. 26%). On internal validation, comparable OS was seen between the respective groups in each cohort (p = 0.77). Conclusions: Our prognostic scoring system will help oncologists to predict the prognosis in de novo stage IV BC patients treated with LRT. Although firm treatment-related conclusions cannot be made due to the retrospective nature of the study, LRT appears to be associated with a better OS in specific subgroups.

AB - Background: The role of locoregional treatment (LRT) remains controversial in de novo stage IV breast cancer (BC). We sought to analyze the role of LRT and prognostic factors of overall survival (OS) in de novo stage IV BC patients treated with LRT utilizing the National Cancer Data Base (NCDB). The objective of the current study is to create and internally validate a prognostic scoring model to predict the long-term OS for de novo stage IV BC patients treated with LRT. Methods: We included de novo stage IV BC patients reported to NCDB between 2004 and 2015. Patients were divided into LRT and no-LRT subsets. We randomized LRT subset to training and validation cohorts. In the training cohort, a seventeen-point prognostic scoring system was developed based on the hazard ratios calculated using Cox-proportional method. We stratified both training and validation cohorts into two “groups” [group 1 (0–7 points) and group 2 (7–17 points)]. Kaplan–Meier method and log-rank test were used to compare OS between the two groups. Our prognostic score was validated internally by comparing the OS between the respective groups in both the training and validation cohorts. Results: Among 67,978 patients, LRT subset (21,200) had better median OS as compared to that of no-LRT (45 vs. 24 months; p < 0.0001). The group 1 and group 2 in the training cohort showed a significant difference in the 3-year OS (p < 0.0001) (68 vs. 26%). On internal validation, comparable OS was seen between the respective groups in each cohort (p = 0.77). Conclusions: Our prognostic scoring system will help oncologists to predict the prognosis in de novo stage IV BC patients treated with LRT. Although firm treatment-related conclusions cannot be made due to the retrospective nature of the study, LRT appears to be associated with a better OS in specific subgroups.

KW - Locoregional therapy

KW - Prediction model

KW - Stage IV breast cancer

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=85049128429&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85049128429&partnerID=8YFLogxK

U2 - 10.1007/s10549-018-4802-2

DO - 10.1007/s10549-018-4802-2

M3 - Article

C2 - 29721715

AN - SCOPUS:85049128429

VL - 170

SP - 677

EP - 685

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 3

ER -