2018 ASCO Annual Meeting!
Session: Breast Cancer—Local/Regional/Adjuvant
Type: Poster Session
Time: Saturday June 2, 8:00 AM to 11:30 AM
Location: Hall A
Comparison of outcomes for AJCC 8th Anatomic and Prognostic staging in contemporary triple negative breast cancer (TNBC) multisite registry.
2018 ASCO Annual Meeting
Poster Board Number:
Poster Session (Board #47)
J Clin Oncol 36, 2018 (suppl; abstr 555)
Author(s): Rajvi H. Shah, Yen Y. Wang, Karissa Finke, Rachel Yoder, Anne O'Dea, Lauren Elizabeth Nye, Sheshadri Madhusudhana, Marc Steven Hoffmann, Manana Elia, Gregory James Crane, Jennifer R. Klemp, Qamar J. Khan, Bruce F. Kimler, Priyanka Sharma; University of Kansas Medical Center, Westwood, KS; Kansas University Medical Center, Westwood, KS; Northwestern University, Feinberg School of Medicine, Chicago, IL; University of Missouri - Kansas City, Kansas City, MO; University of Kansas Cancer Center, Mission Hill, KS; University of Kansas Cancer Center, Overland Park, KS; University of Kansas Cancer Center, Westwood, KS; University of Kansas Medical Center, Kansas City, KS
Background: Eighth edition of the AJCC TNM staging system incorporates biological prognostic factors along with the traditional anatomical factors and currently Prognostic (P) stage must be used for reporting of all cancer patients in the US. Comparison of patient distribution between P and Anatomic staging and outcomes associated with the P stages in a contemporary TNBC population are not known. Methods: 574 patients with stage I-III TNBC were enrolled in an IRB approved multisite prospective registry between 2011 and 2017. Patients were followed for recurrence and survival. AJCC 8th edition Anatomic (A) Stage and clinical Prognostic (P) stage groups were applied to all patients. Recurrence free survival (RFS) (STEEP criterion) was estimated according to the Kaplan-Meier method and compared among groups by log-rank test. Results: Median age was 53 years (23-85). 96% of patients received neo/adjuvant chemotherapy. 82% (468/574) of patients were upstaged on P compared to A staging. Significantly lower numbers of patients were categorized within P stage II (36%) compared to A stage II (51%) (p = 0.001). Conversely, higher number of patients were categorized within P stage III (29%) compared to A stage III (14%) (p = 0.0001), with largest relative increase in stage IIIC (3% to 13%). Table 1 provides 5 years RFS for all A and P stages. Compared to A stage IIIAB, P stage IIIAB was associated with better RFS (HR = 0.42 [0.21-0.86]; p = 0.013), whereas P and A stages IIIC had similar RFS. This suggests appropriate upstaging of TNBC patients to IIIC on P staging. Conclusions: 82% of TNBC patients are upstaged on P staging compared to A staging. Knowledge of outcomes associated with various P stages can guide prognostic counselling for TNBC patients who plan to undergo standard local and systemic treatment.
|N = 574||Stage||P value||5 year RFS (Est)|
|Stage I||200 (35%)||199 (35%)||NS||86%||87%|
|IA||197 (34%)||3 (1%)||0.001||86%||100%|
|IB||3 (1%)||196 (34%)||67%||87%|
|Stage II||293 (51%)||207 (36%)||0.001||85%||86%|
|IIA||205 (35%)||80 (14%)||0.0001||87%||91%|
|IIB||88 (15%)||127 (22%)||80%||83%|
|Stage III||81 (14%)||168 (29%)||0.0001||57%||70%|
|IIIAB||66 (12%)||94 (16%)||0.0001||59%||83%|
|IIIC||15 (3%)||74 (13%)||55%||54%|
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