Abstract
Introduction Knowledge of the effect of prior cancer on long-term survival outcomes for patients with nonmetastatic triple-negative breast cancer (TNBC) remained unclear. The aim of this study was to explore and identify the effectiveness of prior cancer on breast cancer-specific death (BCSD) and other cause-specific death (OCSD) in patients with nonmetastatic TNBC. Materials and Methods Data of 29,594 participants with nonmetastatic TNBC patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. Prognostic predictors were identified by propensity score matching (PSM) analysis combined with univariate cumulative incidence function (CIF) and multivariate Fine and Gray competitive risk analyses. Results Among the women with nonmetastatic TNBC included in the unmatched cohort, a total of 5,375 (18.2%) subjects had prior cancers (P-TNBC) and 24,219 (81.8%) had no prior cancer (NP-TNBC). Patients with P-TNBC tended to have poorer BCSD (Gray's test, p=0.0131) and OCSD (Gray's test, p=0.0009) in comparison with those with NP-TNBC after PSM. However, the risk of BCSD (p=0.291) and OCSD (p=0.084) found no difference among P-TNBC patients with one prior cancer and two or more prior cancers after PSM. Additionally, subjects with younger age, advanced T stage, advanced N stage, and advanced differentiation grade tumors were likely to develop BCSD, whereas those with breast-conserving surgery (BCS), radiotherapy, or chemotherapy tended to have a lower incidence of BCSD. Conclusion Our study demonstrated that prior cancer was related to the worse BCSD and OCSD rate and could be identified as a reliable survival predictor for patients with nonmetastatic TNBC. This study may provide some reference value for the treatment mode of TNBC patients with prior cancer in the future.
Highlights
Knowledge of the effect of prior cancer on long-term survival outcomes for patients with nonmetastatic triplenegative breast cancer (TNBC) remained unclear. e aim of this study was to explore and identify the effectiveness of prior cancer on breast cancer-specific death (BCSD) and other cause-specific death (OCSD) in patients with nonmetastatic TNBC
We explored whether prior cancer history would affect the treatment decisions of patients with TNBC and whether different treatment decisions would affect the prognosis of such patients. erefore, we conducted this study using the SEER database to determine the impact of prior cancer on BCSD and OCSD in patients with TNBC through propensity score matching (PSM) analysis. en, we identified the prognosis factors of BCSD and OCSD through competitive risk analysis in patients with prior cancers of TNBC (P-TNBC)
We found that P-TNBC patients younger than 40 years or older than 80 years; black race; single status; advanced differentiation grade; advanced T stage; advanced N stage; receiving mastectomy, chemotherapy, or no radiotherapy were accompanied by high cumulative incidences of BCSD
Summary
Knowledge of the effect of prior cancer on long-term survival outcomes for patients with nonmetastatic triplenegative breast cancer (TNBC) remained unclear. e aim of this study was to explore and identify the effectiveness of prior cancer on breast cancer-specific death (BCSD) and other cause-specific death (OCSD) in patients with nonmetastatic TNBC. Knowledge of the effect of prior cancer on long-term survival outcomes for patients with nonmetastatic triplenegative breast cancer (TNBC) remained unclear. E aim of this study was to explore and identify the effectiveness of prior cancer on breast cancer-specific death (BCSD) and other cause-specific death (OCSD) in patients with nonmetastatic TNBC. Our study demonstrated that prior cancer was related to the worse BCSD and OCSD rate and could be identified as a reliable survival predictor for patients with nonmetastatic TNBC. The improvement in survival undoubtedly contributed to increased cumulative incidences of multiple primary cancers (MPCs) [3, 4] and corresponding histories of prior cancer, the prognosis of which was influenced differently by diverse tumor types [5]. TNBC seemed like a highly invasive and heterogeneous tumor, usually manifested as high-grade invasive ductal carcinoma and often accompanied by distant metastasis, with a higher rate of early
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