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. 2020 Dec;122(8):1761-1769.
doi: 10.1002/jso.26216. Epub 2020 Oct 30.

Time to surgery following neoadjuvant chemotherapy for breast cancer impacts residual cancer burden, recurrence, and survival

Thomas L Sutton  1 , Alexander Schlitt  2 , Stuart K Gardiner  3 , Nathalie Johnson  4 , Jennifer R Garreau  4
Affiliations

Time to surgery following neoadjuvant chemotherapy for breast cancer impacts residual cancer burden, recurrence, and survival

Thomas L Sutton et al. J Surg Oncol. 2020 Dec.

Abstract

Background: The impact of length of time to surgery (TTS) on oncologic outcomes following neoadjuvant chemotherapy (NAC) in breast cancer patients is unclear. We investigated the relationship between TTS on residual cancer burden (RCB) score and oncologic outcomes.

Methods: Patients with breast cancer receiving NAC from 2011 to 2017 were identified. The association of TTS with recurrence-free survival (RFS), overall and disease-specific survival (OS, DSS), and RCB score was examined with Kaplan-Meier and Cox proportional hazards analysis, adjusting for relevant clinicopathologic factors.

Results: We identified 463 patients. Median TTS was 29 days (range 11-153). Median follow-up was 57 months (range, 2-93 months). Five-year local recurrence-free survival, locoregional RFS, OS, and DSS was 86%, 96%, 89%, and 91%, respectively. On multivariate analysis, TTS >6 weeks was independently associated with worse RFS (HR [hazard ratio] 3.45; p < .001) and DSS (HR 2.82; p < .05), while TTS >6 weeks was independently associated with a positive size of the effect on RCB score of 0.59 (p < .0001).

Conclusion: Prolonged TTS is a modifiable risk factor for adverse oncologic outcomes following NAC for breast cancer, possibly mediated by increasing RCB score overtime after NAC. In the absence of contraindications, surgery should be performed within 6 weeks following NAC for optimal oncologic outcomes.

Keywords: breast cancer; neoadjuvant chemotherapy; oncologic outcomes; time to surgery.

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References

REFERENCES

    1. Garrer WY, El Hossieny HA, Gad ZS, et al. Appropriate timing of surgery after neoadjuvant chemoradiation therapy for locally advanced rectal cancer. Asian Pac J Cancer Prev. 2016;17(9):4381-4389.
    1. Akgun E, Caliskan C, Bozbiyik O, et al. Randomized clinical trial of short or long interval between neoadjuvant chemoradiotherapy and surgery for rectal cancer. Br J Surg. 2018;105(11):1417-1425.
    1. Furukawa T, Hamai Y, Hihara J, et al. Impact of interval between neoadjuvant chemoradiation and surgery upon morbidity and survival of patients with squamous cell carcinoma of thoracic esophagus. Anticancer Res. 2018;38(9):5239-5245.
    1. Chen M, Chen Z, Xu M, et al. Impact of the time interval from neoadjuvant chemotherapy to surgery in primary ovarian, tubal, and peritoneal cancer patients. J Cancer. 2018;9(21):4087-4091.
    1. Omarini C, Guaitoli G, Noventa S, et al. Impact of time to surgery after neoadjuvant chemotherapy in operable breast cancer patients. Eur J Surg Oncol. 2017;43(4):613-618.

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