Abstract
Background
The optimal time interval between the end of neoadjuvant systemic therapy (NST) and
breast surgery is still unclear. It is not known if a delay in surgery might influence
the benefit of primary chemotherapy. The aim of this study is to evaluate the relationship
between time to surgery (TTS) and survival outcomes.
Patients and methods
According to TTS, women with diagnosis of BC treated with NST were divided into two
cohorts: group A = 21 days or fewer and group B = longer than 21 days. OS and RFS
were estimated and compared according to TTS and known prognostic factors.
Results
A total of 319 patients were included in the study: 61 in group A and 258 in group
B. Median TTS was 34 days. No association between clinical stage, nuclear grade, type
of chemotherapy, type of surgery and TTS was detected. OS and RFS were significantly
worse for group B compared with group A, with a hazard ratio of 3.1 (95% CI, 1.1–8.6
p = 0.03) and 3.1 (95% CI, 1.3–7.1 p = 0.008) respectively. Multivariate analysis
confirmed that TTS was an independent prognostic factor in term of OS (p = 0.03) and
RFS (p = 0.01). Even in the subgroup of patients with pCR, TTS continued to be an
independent prognostic factor for both OS and RFS (p = 0.05 and p = 0.03).
Conclusions
TTS after NST seems to influence survival outcomes. BC patients underwent surgery
within 21 days experienced maximal benefit from previous treatment: this advantage
is consistent and maintained over time.
Keywords
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Article info
Publication history
Published online: October 20, 2016
Accepted:
September 26,
2016
Identification
Copyright
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
