Impact of time to surgery after neoadjuvant chemotherapy in operable breast cancer patients

Omarini, Claudia; Guaitoli, Giorgia; Noventa, Silvia; Andreotti, Alessia; Gambini, Anna; Palma, Enza Di; Papi, Simona; Tazzioli, Giovanni; Balduzzi, Sara; Dominici, Massimo; Cascinu, Stefano; Piacentini, Federico

doi:10.1016/j.ejso.2016.09.020

Cited by 52 publications

(56 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Eight systematic reviews, four studies on metastatic breast cancer, and eleven non-neoadjuvant chemotherapy were further excluded. Eventually, nine articles [11][12][13][14][15][16][17][18][19] (eight studies) were identi ed as eligible for our analysis, including eight independent studies for OS, six studies for RFS, and two for DFS [14]. The ow chart of the literature search and study selection is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

The relationship between time to surgery(TTS) after neoadjuvant chemotherapy (NAC)and survival in breast cancer patients: meta-analysis

Zheng

2020

Preprint

View full text Add to dashboard Cite

PURPOSE: This meta-analysis aims to evaluate the impact of delaying surgery in operable breast tumor patients after neoadjuvant chemotherapy (NAC) on survival.METHODS: An electronic literature retrieval was conducted on PubMed/Medline and EMBASE((between January 2000 and June 2020).The primary end point was overall survival(OS),secondary end points included disease-free survival (DFS) or recurrence-free survival (RFS).The HR with 95% confidence intervals were calculated using a random-effects or fixed-effects model.RESULTS: The combined HR for OS was 1.52(95% CI 1.29-1.78; P = 0.000) by fixed-effects model.No statistically significant heterogeneity was found (P=0.114;I2=39.8%).The pooled HR for RFS/DFS was 1.47 (95%CI: 1.27- 1.71,I2=61.9%) by random-effects model, with significant heterogeneity.CONCLUSION: Our meta-analysis revealed a significant adverse association between longer TTS after NAC and more inferior OS and RFS/DFS in patients with breast cancer.Clinicians and patients should minimize surgical delay after NAC as much as possible.

show abstract

Section: Resultsmentioning

confidence: 99%

The relationship between time to surgery(TTS) after neoadjuvant chemotherapy (NAC)and survival in breast cancer patients: meta-analysis

Zheng

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…There have been several recent examinations of TTS following NAC in an attempt to better define the optimal interval. An examination of TTS based on an interval of more (258 patients) or less than 21 days (61 patients) found that OS and RFS were significantly worse for the group with a TTS >21 days (HR 3.1, 1.1‐8.6, P = .03; 3, 1.3‐7.1, P = .008, respectively) . Median TTS was 34 days, similar to 35 days noted in our cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the increasing utilization of NAC, the ideal interval between the completion of neo‐adjuvant chemotherapy and the definitive surgical management of patients with breast cancer remains unclear. There are a few recent publications examining with topic without definitive consensus . The current study sought to determine the relationship between the time interval from completion of chemotherapy to surgery in an attempt to define the best practice.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Time from Completion of Neo‐adjuvant Chemotherapy to Surgery: Effects on Outcomes in Breast Cancer Patients

et al. 2019

View full text Add to dashboard Cite

There is no consensus on the ideal time interval between the completion of neo‐adjuvant chemotherapy (NAC) and definitive surgery for patients with breast cancer. This study sought to determine the ideal time interval from completion of systemic therapy to surgery in an attempt to define a best practice. A retrospective analysis of all patients undergoing NAC for Stage I‐III breast cancer from 1998‐2010 was undertaken. Analysis of all demographic and clinical information was performed, with emphasis on interval from completion of systemic therapy to definitive surgical management. Three hundred and eighty eight patients met the inclusion criteria with a median age of 50 (61.9% white, 33.8% black and 4.3% other). Overall, 2.8% of patients were Stage I, 57.2% Stage II and 40% Stage III. Median follow‐up was 85 months. Pathologic response to systemic therapy was complete in 20.6%, partial in 67.8% and no response or progression in 11.6%; responders (pCR or pPR) were noted to have significantly improved Disease free survival (DFS) and Overall survival (OS). Patients undergoing surgical intervention 4‐6 weeks after completion of NAC were noted to have a trend towards improved DFS and OS on multivariable analysis. These findings were also observed in the nonlinear relationship between survival risk and surgery time window using martingale residual plots. Timing of surgical intervention following the receipt of NAC may not appear to affect DFS or OS.

show abstract

“…There are also several studies [9,11,14] investigating the impact of timing of surgery after NAC on survival, suggesting that the delay of surgery after NAC shows poorer survival. In a word, for patients who received NAC, the best time of surgery after NAC is < 3 weeks, and not > 8 weeks.…”

Section: Daily Medical Treatments Of Cancer Patients Have Been Affectmentioning

confidence: 99%

Treatment for breast cancer patients during the special period of novel coronavirus pneumonia outbreak

Pan

Xie

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose: The outbreak of novel coronavirus pneumonia occurred worldwide. 2019 novel coronavirus disease (COVID-19) can be transmitted from human to human, cause hospital infection, and seriously threatens surgical staffs and inpatients. The treatment of patients with breast cancer may be affected in this special period. Methods: From 24th January to 8th March 2020, patients diagnosed with breast cancer were enrolled from 16 hospitals in Jiangsu Province, and patients, who were candidates for surgery after neoadjuvant chemotherapy, were also enrolled. Patients from 24th January to 8th March 2019 were included as control with the same criteria. Results: In 2019, 520 patients were diagnosed with breast cancer in these 16 hospital; however, only 229 patients (decreased by 56%) were diagnosed with breast cancer in the same period of 2020. The clinical characteristics were similar between the two groups, and core biopsy was performed to more patients in 2020 than that in 2019 (4.1 days ±3.2 vs 3.2 days ±2.6, P < 0.001), and more patients underwent mastectomy and axillary lymph node dissection in 2020. After neoadjuvant chemotherapy, the mean interval between last time of neoadjuvant chemotherapy and surgery in 2020 was significantly longer than that in 2019 (29.2 days ±11.1 vs 17.7 days ±8.2, P < 0.001). After examinations to rule out COVID-19, no COVID-19 was found in any patient. Conclusions: In the special period of novel coronavirus pneumonia outbreak, the treatment of patients with breast cancer was delayed, but the treatment was safe after strict exclusions of COVID-19.

show abstract

Impact of time to surgery after neoadjuvant chemotherapy in operable breast cancer patients

Cited by 52 publications

References 13 publications

The relationship between time to surgery(TTS) after neoadjuvant chemotherapy (NAC)and survival in breast cancer patients: meta-analysis

The relationship between time to surgery(TTS) after neoadjuvant chemotherapy (NAC)and survival in breast cancer patients: meta-analysis

Time from Completion of Neo‐adjuvant Chemotherapy to Surgery: Effects on Outcomes in Breast Cancer Patients

Treatment for breast cancer patients during the special period of novel coronavirus pneumonia outbreak

Contact Info

Product

Resources

About