Ten-year conditional recurrence risks and overall and relative survival for breast cancer patients in the Netherlands: Taking account of event-free years

Marissa C. van Maaren* (Corresponding Author), Luc J.A. Strobbe, Marjolein L. Smidt, Martine Moossdorff, Philip M.P. Poortmans, Sabine Siesling

*Corresponding author for this work

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Abstract

Background: Survival estimates from diagnosis are of limited importance for (ex-)breast cancer patients who survived several years, as it includes information on already deceased patients. This study analysed the 10-year conditional risk of recurrent breast cancer in specific prognostic subgroups. Second, we investigated 10-year conditional overall survival (OS) and relative survival (RS), adjusted for confounding.

Patients and methods: All women diagnosed in 2005 with operated T1-2N0-1 breast cancer were selected from the Netherlands Cancer Registry. Patients were classified into T1N0, T1N1, T2N0 and T2N1 stage. Ten-year conditional recurrence rates were calculated from diagnosis, and for patients without an event (local [LR], regional recurrence [RR], distant metastasis [DM] or death) every year following diagnosis. Ten-year conditional OS was calculated using multivariable Cox regression. RS was estimated by dividing patient survival rates by those of the general Dutch population.

Results: We included 7969 patients: 52.3% had T1N0, 15.3% T1N1, 19.9% T2N0 and 12.5% T2N1 stage. For T1N0, 10-year LR rates changed from 4.6% at diagnosis to 0.5% in year 10. RR rates changed from 2.3% to 0.2%, and DM rates changed from 7.8% to 0.6%. For T2N1 stage, the LR, RR and DM rates changed from 6.2% to 0.8%, 5.2%–0.4% and 19.6%–1.5%, respectively. For the luminal A subtype, LR, RR and DM rates changed from 3.9% to 0.4%, 1.7%–0.5% and 7.3%–1.1%, while for triple negative, these rates changed from 5.6% to 0.7%, 4.9%–0.2% and 16.7%–0%, respectively. Differences between subgroups attenuated over time, and all recurrence rates became ≤1.5% in year 10. Ten-year OS and RS, adjusted for confounding, showed declining risk differences between subgroups over time.

Conclusion: Differences in recurrence rates, OS and RS between prognostic subgroups declined as years passed by. These results highlight the importance of taking into account disease-free years to more accurately predict (ex-)breast cancer patients’ prognosis over time.

Original languageEnglish
Pages (from-to)82-94
Number of pages13
JournalEuropean journal of cancer
Volume102
DOIs
Publication statusPublished - Oct 2018

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Netherlands
Breast Neoplasms
Recurrence
Survival
Neoplasm Metastasis
Survival Rate
Registries
Population
Neoplasms

Keywords

  • 10-Year survival
  • Breast cancer
  • Conditional survival
  • Recurrence
  • Relative survival
  • Survivors

Cite this

@article{e2b94f2ae35048a9bb99cd8d5ce27135,
title = "Ten-year conditional recurrence risks and overall and relative survival for breast cancer patients in the Netherlands: Taking account of event-free years",
abstract = "Background: Survival estimates from diagnosis are of limited importance for (ex-)breast cancer patients who survived several years, as it includes information on already deceased patients. This study analysed the 10-year conditional risk of recurrent breast cancer in specific prognostic subgroups. Second, we investigated 10-year conditional overall survival (OS) and relative survival (RS), adjusted for confounding.Patients and methods: All women diagnosed in 2005 with operated T1-2N0-1 breast cancer were selected from the Netherlands Cancer Registry. Patients were classified into T1N0, T1N1, T2N0 and T2N1 stage. Ten-year conditional recurrence rates were calculated from diagnosis, and for patients without an event (local [LR], regional recurrence [RR], distant metastasis [DM] or death) every year following diagnosis. Ten-year conditional OS was calculated using multivariable Cox regression. RS was estimated by dividing patient survival rates by those of the general Dutch population.Results: We included 7969 patients: 52.3{\%} had T1N0, 15.3{\%} T1N1, 19.9{\%} T2N0 and 12.5{\%} T2N1 stage. For T1N0, 10-year LR rates changed from 4.6{\%} at diagnosis to 0.5{\%} in year 10. RR rates changed from 2.3{\%} to 0.2{\%}, and DM rates changed from 7.8{\%} to 0.6{\%}. For T2N1 stage, the LR, RR and DM rates changed from 6.2{\%} to 0.8{\%}, 5.2{\%}–0.4{\%} and 19.6{\%}–1.5{\%}, respectively. For the luminal A subtype, LR, RR and DM rates changed from 3.9{\%} to 0.4{\%}, 1.7{\%}–0.5{\%} and 7.3{\%}–1.1{\%}, while for triple negative, these rates changed from 5.6{\%} to 0.7{\%}, 4.9{\%}–0.2{\%} and 16.7{\%}–0{\%}, respectively. Differences between subgroups attenuated over time, and all recurrence rates became ≤1.5{\%} in year 10. Ten-year OS and RS, adjusted for confounding, showed declining risk differences between subgroups over time.Conclusion: Differences in recurrence rates, OS and RS between prognostic subgroups declined as years passed by. These results highlight the importance of taking into account disease-free years to more accurately predict (ex-)breast cancer patients’ prognosis over time.",
keywords = "10-Year survival, Breast cancer, Conditional survival, Recurrence, Relative survival, Survivors",
author = "{van Maaren}, {Marissa C.} and Strobbe, {Luc J.A.} and Smidt, {Marjolein L.} and Martine Moossdorff and Poortmans, {Philip M.P.} and Sabine Siesling",
year = "2018",
month = "10",
doi = "10.1016/j.ejca.2018.07.124",
language = "English",
volume = "102",
pages = "82--94",
journal = "European journal of cancer",
issn = "0959-8049",
publisher = "Elsevier",

}

Ten-year conditional recurrence risks and overall and relative survival for breast cancer patients in the Netherlands : Taking account of event-free years. / van Maaren, Marissa C. (Corresponding Author); Strobbe, Luc J.A.; Smidt, Marjolein L.; Moossdorff, Martine; Poortmans, Philip M.P.; Siesling, Sabine.

In: European journal of cancer, Vol. 102, 10.2018, p. 82-94.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Ten-year conditional recurrence risks and overall and relative survival for breast cancer patients in the Netherlands

T2 - Taking account of event-free years

AU - van Maaren, Marissa C.

AU - Strobbe, Luc J.A.

AU - Smidt, Marjolein L.

AU - Moossdorff, Martine

AU - Poortmans, Philip M.P.

AU - Siesling, Sabine

PY - 2018/10

Y1 - 2018/10

N2 - Background: Survival estimates from diagnosis are of limited importance for (ex-)breast cancer patients who survived several years, as it includes information on already deceased patients. This study analysed the 10-year conditional risk of recurrent breast cancer in specific prognostic subgroups. Second, we investigated 10-year conditional overall survival (OS) and relative survival (RS), adjusted for confounding.Patients and methods: All women diagnosed in 2005 with operated T1-2N0-1 breast cancer were selected from the Netherlands Cancer Registry. Patients were classified into T1N0, T1N1, T2N0 and T2N1 stage. Ten-year conditional recurrence rates were calculated from diagnosis, and for patients without an event (local [LR], regional recurrence [RR], distant metastasis [DM] or death) every year following diagnosis. Ten-year conditional OS was calculated using multivariable Cox regression. RS was estimated by dividing patient survival rates by those of the general Dutch population.Results: We included 7969 patients: 52.3% had T1N0, 15.3% T1N1, 19.9% T2N0 and 12.5% T2N1 stage. For T1N0, 10-year LR rates changed from 4.6% at diagnosis to 0.5% in year 10. RR rates changed from 2.3% to 0.2%, and DM rates changed from 7.8% to 0.6%. For T2N1 stage, the LR, RR and DM rates changed from 6.2% to 0.8%, 5.2%–0.4% and 19.6%–1.5%, respectively. For the luminal A subtype, LR, RR and DM rates changed from 3.9% to 0.4%, 1.7%–0.5% and 7.3%–1.1%, while for triple negative, these rates changed from 5.6% to 0.7%, 4.9%–0.2% and 16.7%–0%, respectively. Differences between subgroups attenuated over time, and all recurrence rates became ≤1.5% in year 10. Ten-year OS and RS, adjusted for confounding, showed declining risk differences between subgroups over time.Conclusion: Differences in recurrence rates, OS and RS between prognostic subgroups declined as years passed by. These results highlight the importance of taking into account disease-free years to more accurately predict (ex-)breast cancer patients’ prognosis over time.

AB - Background: Survival estimates from diagnosis are of limited importance for (ex-)breast cancer patients who survived several years, as it includes information on already deceased patients. This study analysed the 10-year conditional risk of recurrent breast cancer in specific prognostic subgroups. Second, we investigated 10-year conditional overall survival (OS) and relative survival (RS), adjusted for confounding.Patients and methods: All women diagnosed in 2005 with operated T1-2N0-1 breast cancer were selected from the Netherlands Cancer Registry. Patients were classified into T1N0, T1N1, T2N0 and T2N1 stage. Ten-year conditional recurrence rates were calculated from diagnosis, and for patients without an event (local [LR], regional recurrence [RR], distant metastasis [DM] or death) every year following diagnosis. Ten-year conditional OS was calculated using multivariable Cox regression. RS was estimated by dividing patient survival rates by those of the general Dutch population.Results: We included 7969 patients: 52.3% had T1N0, 15.3% T1N1, 19.9% T2N0 and 12.5% T2N1 stage. For T1N0, 10-year LR rates changed from 4.6% at diagnosis to 0.5% in year 10. RR rates changed from 2.3% to 0.2%, and DM rates changed from 7.8% to 0.6%. For T2N1 stage, the LR, RR and DM rates changed from 6.2% to 0.8%, 5.2%–0.4% and 19.6%–1.5%, respectively. For the luminal A subtype, LR, RR and DM rates changed from 3.9% to 0.4%, 1.7%–0.5% and 7.3%–1.1%, while for triple negative, these rates changed from 5.6% to 0.7%, 4.9%–0.2% and 16.7%–0%, respectively. Differences between subgroups attenuated over time, and all recurrence rates became ≤1.5% in year 10. Ten-year OS and RS, adjusted for confounding, showed declining risk differences between subgroups over time.Conclusion: Differences in recurrence rates, OS and RS between prognostic subgroups declined as years passed by. These results highlight the importance of taking into account disease-free years to more accurately predict (ex-)breast cancer patients’ prognosis over time.

KW - 10-Year survival

KW - Breast cancer

KW - Conditional survival

KW - Recurrence

KW - Relative survival

KW - Survivors

UR - http://www.scopus.com/inward/record.url?scp=85051789471&partnerID=8YFLogxK

U2 - 10.1016/j.ejca.2018.07.124

DO - 10.1016/j.ejca.2018.07.124

M3 - Article

AN - SCOPUS:85051789471

VL - 102

SP - 82

EP - 94

JO - European journal of cancer

JF - European journal of cancer

SN - 0959-8049

ER -