Abstract P2-07-12: The association between patient comorbidity and breast cancer survival

Abstract

Abstract Background There are studies suggesting significant association between the patient's comorbidity and perioperative outcomes. In breast cancer, patient comorbidity can also influence the oncologic outcome by affecting the decisions regarding adjuvant treatments. In this study, we examined the long-term oncologic outcome in breast cancer patients who underwent curative surgery according to their pre-existing comorbid conditions. Methods The medical records of 2,501 patients who underwent surgery for primary breast cancer from June 2006 to June 2010 were reviewed retrospectively. The patients were classified into three groups (ASA 1, 2, 3) according to preoperative ASA status determined by the anesthesiologists. Clinico-pathologic characteristics and survival outcomes of the patients were compared among the different co-morbidity groups. Result There were 1,792 (71.6%), 665 (26.6%), and 44 (1.8%) patients in ASA 1, 2, and 3, respectively. Total 95 (3.8%) deaths and 269 (10.8%) recurrences (loco-regional and distant) occurred during the median follow-up period of 71 months. Patients with high comorbidity showed significantly higher rate of death (51 (2.8%), 38 (5.7%) and 6 (13.6%) deaths in ASA 1, 2 and 3 group, respectively, p<0.001). The ASA 3 patients also showed significantly higher rate of breast cancer recurrence when compared to other groups (180 (10.0%), 80 (12.0%) and 9 (20.5%) in ASA 1, 2 and 3, respectively, p=0.041). Cox multivariate analysis demonstrated that high ASA score (ASA 3) was an independent prognostic factor in DFS, OS and BCSS (95% confidence interval [CI], 1.661-6.780; p=0.001, 1.753-11.321; p=0.002 and 2.222-18.429; p=0.001). Fewer patients in the high co-morbidity group received adjuvant therapies (77 (4.3%), 44 (6.6%) and 8 (18.2%) in ASA 1, 2 and 3, p<0.001). The increased recurrence of breast cancer in the high morbidity group was most seen in patients who did not receive adjuvant therapies. The incidence of serious adverse effect during the adjuvant therapy did not differ according to the co-morbidity conditions. Conclusion In this study, high comorbidity was related to increased risk of death and recurrence in breast cancer. The increased risk of recurrence in high co-morbidity group was mostly seen in patients who did not receive adjuvant therapies. In patients who underwent the adjuvant therapies, the incidence of serious adverse effects did not differ according to the co-morbidity status. Citation Format: Han J, Lee H-B, Lee E-S, Kang YJ, Kim Y, Choi J, Rhu J, Han W, Noh D-Y, Moon H-G. The association between patient comorbidity and breast cancer survival [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-07-12.