Table 3.
Multivariate Analysis of Hormonal Therapy Adherence and Cancer-Related Death and Cancer Recurrence.
| Outcome | ||
|---|---|---|
|
| ||
| Time to Cancer-Related Death Hazard Ratio (95% CI) |
Cancer Recurrence Odds Ratio (95% CI) |
|
|
| ||
| MPR Adherence (0–100%) | 1.18 (0.54–2.59) | 1.49 (0.78–2.84) |
|
| ||
| Age (Years) | ||
| <45 | 0.84 (0.41– 1.72) | 2.89 (1.42–5.88) |
| 45–54 | 0.69 (0.32–1.53) | 2.26(1.26–4.06) |
| 55–64 | 0.80 (0.44–1.43) | 1.57 (0.98–2.52) |
| 65–74 | 1.13(0.69–1.87) | 1.17 (0.75–1.81) |
| 75+ | Reference | Reference |
|
| ||
| Race, other vs white | 1.35 (0.89–2.03) | 1.81 (1.28– 2.56) |
|
| ||
| Cancer Stage (Local vs Regional) | 1.17 (0.30–4.58) | 0.35 (0.08–1.56) |
|
| ||
| Adjuvant Hormonal Therapy Medications | ||
| Tamoxifen only | 0.38(0.20– 0.70) | 0.89(0.47–1.67) |
| AI only | 0.25 (0.09–0.69) | 0.64 (0.29–1.39) |
| Tamoxifen concurrent with AI | Reference | Reference |
|
| ||
| Surgery Type, Breast-conserving vs mastectomy | 0.88 (0.49–1.55) | 1.86 (1.17– 2.95) |
|
| ||
| Adjuvant Cancer Treatment (yes vs no) | ||
| Chemotherapy | 1.40 (0.87–2.24) | 1.27 (0.85–1.88) |
| Radiation | 0.95(0.59–1.53) | 1.56 (1.02–2.38) |
|
| ||
| Number of Positive Lymph nodes | ||
| Negative | Reference | Reference |
| 1–3 | 1.70 (0.41–7.10) | 0.48 (0.10– 2.22) |
| 4–9 | 2.78 (0.69–11.28) | 0.92 (0.20– 4.24) |
| 10+ | 6.54 (1.53–28.00) | 3.44(0.62–19.06) |
| Not Examined | 0.95 (0.44–2.08) | 0.72 (0.42–1.25) |
|
| ||
| Tumor Grade | ||
| Low | Reference | Reference |
| Intermediate | 1.34 (0.58–3.11) | 0.88 (0.53–1.43) |
| High | 4.39 (1.95–9.87) | 2.37 (1.40–4.00) |
| Undetermined | 1.80 (0.75–4.30) | 1.24 (0.71–2.17) |
|
| ||
| Hormone Receptor Status (positive vs undetermined) | 0.85 (0.54, 1.34) | 0.83 (0.57, 1.20) |
|
| ||
| Charlson Comorbidity Index | 1.07 (0.97–1.18) | 1.05 (0.97– 1.20) |
|
| ||
| Use of CYP2D6 Inhibitor Medications (yes vs no) | 0.83 (0.54–1.25) | 0.93 (0.66–1.30) |
|
| ||
| Number of Unique Prescription Medications | 1.00 (1.00– 1.01) | 1.00 (1.00–1.00) |
MPR= Medication Possession Ratio; CYP2D6= Cytochrome P450 2D6 enzyme; Cox proportional hazard models were used to calculate the hazard ratio for time to cancer-related death from hormonal therapy initiation date. Logistic regression models were used to calculate the odds ratio for cancer recurrence. Multivariate analyses also controlled for year of initiation of hormonal therapy and urban vs non-urban residence.