Comparison of breast-conserving surgery and mastectomy in early breast cancer using observational data revisited: a propensity score-matched analysis

被引:0
作者
Kai Chen
Zihao Pan
Liling Zhu
Tingting Hu
Min Peng
Weijuan Jia
Fengxi Su
Shunrong Li
Erwei Song
机构
[1] Sun Yat-sen University,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat
[2] Sun Yat-sen University,sen Memorial Hospital
[3] Sun Yat-sen University,Breast Tumor Center, Sun Yat
[4] Chinese Academy of Sciences,sen Memorial Hospital
来源
Science China Life Sciences | 2018年 / 61卷
关键词
breast-conserving surgery; mastectomy; breast cancer; propensity score; survival;
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学科分类号
摘要
Recent observational studies showed that breast-conserving surgery (BCS) resulted in superior survival compared to mastectomy in breast cancer patients. This study compared the clinical outcomes of BCS and mastectomy using propensity score (PS) matching analysis, which had advantages over conventional methods in reducing bias. Nonmetastatic breast cancer patients who underwent BCS and mastectomy were matched 1:1 based on their PS. We used the Kaplan-Meier method and Cox-regression model to estimate the treatment effects. A total of 2,866 patients with a median follow-up time of 67 months were included in the original study population. Although the mastectomy cohort (N=1,219) had more advanced disease compared to the BCS cohort (N=1,647), LRFS was similar between the two groups (93.8% vs. 92.4%, P>0.05). BCS (vs. mastectomy) was associated with improved DFS (73.8% vs. 58.7%, P<0.01) and CSS (91% vs. 78.2%, P<0.01) in the original population. In the PS-matched population (N=1,668), clinicopathological features were equally distributed between the two cohorts. BCS (vs. mastectomy) was not associated with improved DFS (70.7% vs. 66.9%, P>0.05) or CSS (87.5% vs. 84.9%, P>0.05). We found that PS methods reduce bias when estimating treatment effects using observational data. BCS and mastectomy show equivalent outcomes in nonmetastatic breast cancer patients.
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页码:1528 / 1536
页数:8
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