Impact of Adjuvant Chemotherapy on Breast Cancer Survival: A Real-World Population

The impact of adjuvant chemotherapy on breast cancer prognosis has been demonstrated in randomized trials, but its impact is unknown in real-world populations. The aim of this study was to evaluate the effect of adjuvant chemotherapy on the survival of breast cancer patients in an unselected populat...

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Bibliographic Details
Published in:PloS one 2015-07, Vol.10 (7), p.e0132853-e0132853
Main Authors: Rossi, Lea, Stevens, Denise, Pierga, Jean-Yves, Lerebours, Florence, Reyal, Fabien, Robain, Mathieu, Asselain, Bernard, Rouzier, Roman
Format: Article
Language:English
Subjects:
Adjuvant chemotherapy
Adult
Aged
Aged, 80 and over
Analysis
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biomarkers, Tumor
Breast cancer
Breast Neoplasms - drug therapy
Breast Neoplasms - mortality
Breast Neoplasms - pathology
Cancer
Cancer patients
Cancer therapies
Care and treatment
Chemotherapy
Chemotherapy, Adjuvant
Clinical medicine
Clinical trials
Collaboration
Family medical history
Female
Health risk assessment
Humans
Invasiveness
Metastases
Metastasis
Middle Aged
Mortality
Multivariate analysis
Neoplasm Grading
Neoplasm Metastasis
Neoplasm Staging
Patients
Population
Prospective Studies
Randomization
Studies
Survival
Survival analysis
Tumor Burden
Variance analysis
Womens health
World population
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Summary:The impact of adjuvant chemotherapy on breast cancer prognosis has been demonstrated in randomized trials, but its impact is unknown in real-world populations. The aim of this study was to evaluate the effect of adjuvant chemotherapy on the survival of breast cancer patients in an unselected population. This prospective cohort study included 32,502 women treated at the Institut Curie between 1981 and 2008 for a first invasive breast cancer without metastasis. The patients were matched based on their propensity score to receive adjuvant chemotherapy. The matching generated a subsample of 9,180 patients with an overlapping propensity score. In the group without chemotherapy, the overall survival (OS) rates at 5 and 10 years of follow-up were 87.6% (95% CI [86.7-88.6]) and 75.0% (95% CI [73.6-76.5]), respectively, versus 92.1% (95% CI [91.3-92.9]) and 81.9% (95% CI [80.6-83.2]), respectively, in the chemotherapy group. Distant disease-free survival (DDFS) was significantly improved in the five first years (absolute benefit of 3.5%). In a multivariate analysis, adjuvant chemotherapy was associated with better OS (HR = 0.75, 95% CI [0.69-0.83], p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0132853