4.6 Article

Prognostic effect of radiotherapy in breast cancer patients underwent immediate reconstruction after mastectomy

Journal

FRONTIERS IN ONCOLOGY
Volume 12, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2022.1010088

Keywords

radiotherapy; breast cancer; immediate breast reconstruction (IBR); the surveillance; epidemiology; and end results (SEER); nomograms

Categories

Funding

  1. National Natural Science Foundation of China [82103129]
  2. Basic Research Program of Natural Science Foundation of Shaanxi Province [2021JQ-422]
  3. Prior Science and Technology Program for Overseas Chinese Talents of Shaanxi Province [2020-015]
  4. Key Research and Development Program of Shaanxi Province [2022KW-01]

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This study aims to evaluate the actual prognostic impact of radiotherapy on breast cancer patients undergoing immediate breast reconstruction and construct survival prediction models. The results showed that radiotherapy can improve overall survival and breast cancer-specific survival in certain stages of patients. The study provides useful prediction tools for personalized treatment.
IntroductionIt is still unclear whether radiotherapy affects the long-term survival of breast cancer (BC) patients after immediate breast reconstruction (IBR). This study aims to evaluate the actual prognostic impact of radiotherapy on BC patients undergoing IBR, and to construct survival prediction models to predict the survival benefit of radiotherapy. MethodsData on eligible BC patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Competing risk models were used to assess breast cause-specific death (BCSD) and non-breast cancer cause-specific death (NBCSD). Kaplan-Meier curve, Cox risk regression model and forest map were used to evaluate and demonstrate overall survival (OS) and breast cancer-specific survival (BCSS). Survival prediction nomograms were used to predict OS and BCSS probabilities. ResultsA total of 22,218 patients were selected, 24.9% received radiotherapy and 75.1% were without radiotherapy. Competing risk models showed that whether BCSD or NBCSD, the cumulative long-term risk of death in the radiotherapy group was higher than that in the non-radiotherapy group. The Kaplan-Meier curve showed that patients with different lymph node metastasis had different radiotherapy benefits. Multivariate stratified analysis showed that radiotherapy after autologous reconstruction was associated with poor BCSS in patients with stage N0, and radiotherapy after autologous reconstruction and combined reconstruction improved OS and BCSS in patients with stage N3. The C-indexes of nomogram (between 0.778 and 0.847) and calibration curves showed the good prediction ability of survival prediction model. ConclusionsRadiotherapy can improve OS and BCSS in N3 stage BC patients undergoing immediate autologous reconstruction after mastectomy. The practical nomograms can be used to predict OS and BCSS of patients with or without radiotherapy, which is helpful for individualized treatment.

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