Table 3.
Multivariable analysis of all-cause mortality for patients receiving neoadjuvant chemotherapy and total mastectomy stratified by clinical stage
| Clinical Stage IIB | Clinical Stage IIIA | Clinical Stage IIIB | Clinical Stage IIIC | ||||||
|---|---|---|---|---|---|---|---|---|---|
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| HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | ||
| Response of AJCC-stages ratio | Equal-stages | ref | < 0.0001 | ref | < 0.0001 | ref | < 0.0001 | ref | 0.0006 |
| ypCR | 0.18 (0.05-0.58) | 0.17 (0.07-0.42) | 0.30 (0.15-0.63) | 0.13 (0.03-0.53) | |||||
| Downstages | 0.64 (0.42-0.96) | 0.50 (0.37-0.66) | 0.57 (0.44-0.75) | 0.59 (0.42-0.83) | |||||
| Upstages | 1.51 (1.03-2.21) | 1.82 (1.39-2.37) | 2.17 (1.64-2.89) | - | |||||
| Age | 20-49 | ref | 0.7656 | ref | 0.4405 | ref | 0.3858 | ref | 0.6774 |
| 50+ | 1.05 (0.77-1.43) | 0.91 (0.72-1.15) | 1.12 (0.87-1.43) | 0.92 (0.64-1.34) | |||||
| diagnosis year | 2007-2010 | ref | 0.7036 | ref | 0.5551 | ref | 0.4552 | ref | 0.5093 |
| 2011-2015 | 1.06 (0.77-1.47) | 0.93 (0.73-1.18) | 0.91 (0.72-1.16) | 1.14 (0.77-1.69) | |||||
| CCI Scores | 0 | ref | 0.0389 | ref | 0.0036 | ref | 0.0430 | ref | 0.0388 |
| 1 | 0.98 (0.63-1.54) | 0.71 (0.49-1.05) | 1.11 (0.79-1.57) | 0.79 (0.44-1.41) | |||||
| 2+ | 1.11 (1.02-1.57) | 1.74 (1.16-2.62) | 1.68 (1.12-2.52) | 1.07 (1.01-1.76) | |||||
| Differentiation | III | ref | 0.0408 | ref | 0.0004 | ref | 0.0340 | ref | 0.0296 |
| II | 0.78 (0.56-0.99) | 0.72 (0.56-0.93) | 0.76 (0.59-0.97) | 0.83 (0.56-0.92) | |||||
| I | 0.66 (0.31-0.94) | 0.19 (0.08-0.46) | 0.58 (0.32-0.94) | 0.49 (0.33-0.98) | |||||
| NACT regimen | Anthracycline | ref | 0.1138 | ref | 0.9713 | ref | 0.4014 | ref | 0.6776 |
| Taxanes | 1.39 (0.97-1.98) | 1.08 (0.80-1.45) | 0.95 (0.71-1.28) | 0.96 (0.63-1.47) | |||||
| Both | 0.92 (0.62-1.38) | 1.04 (0.78-1.39) | 1.14 (0.87-1.49) | 1.15 (0.72-1.86) | |||||
| Neither | 1.40 (0.83-2.35) | 1.05 (0.66-1.65) | 1.37 (0.82-2.28) | 1.53 (0.58-4.01) | |||||
| Nodal surgery | ALND | ref | 0.9488 | ref | 0.5288 | ref | 0.6781 | ref | 0.4133 |
| SLNB | 1.09 (0.53-2.24) | 0.88 (0.41-1.88) | 0.65 (0.23-1.80) | 1.11 (0.32-1.83) | |||||
| Adjuvant PMRT | No | ref | 0.8612 | ref | < 0.0001 | ref | 0.0136 | ref | 0.0227 |
| Yes | 0.97 (0.70-1.35) | 0.57 (0.44-0.74) | 0.82 (0.65-0.93) | 0.67 (0.43-0.95) | |||||
| Hormone receptors positive | No | ref | 0.0459 | ref | < 0.0001 | ref | 0.0128 | ref | 0.0010 |
| Yes | 0.75 (0.55-0.92) | 0.61 (0.48-0.77) | 0.74 (0.59-0.94) | 0.54 (0.37-0.78) | |||||
| HER2 positive | No | ref | 0.6962 | ref | 0.4107 | ref | 0.8489 | ref | 0.1361 |
| Yes | 1.07 (0.77-1.47) | 1.10 (0.88-1.38) | 1.02 (0.81-1.28) | 1.02 (0.49-1.08) | |||||
| Academic Hospitals | Yes | ref | 0.6800 | ref | 0.0714 | ref | 0.2342 | ref | 0.2775 |
| No | 1.07 (0.78-1.46) | 0.80 (0.64-1.02) | 0.87 (0.69-1.10) | 1.21 (0.86-1.71) | |||||
HR, hazard ratio; CI, confidence interval; PMRT, postmastectomy radiation therapy; NACT, neoadjuvant chemotherapy; HER2, human epidermal growth factor receptor 2; ALND, axillary lymph node dissection; SLNB, sentinel lymph node biopsy; CCI, Charlson comorbidity index; AJCC, American Joint Committee on Cancer.