Caspian journal of internal medicine · 2026
Relapse-free survival and metastasis-free survival between patients with breast cancer receiving adjuvant or neoadjuvant therapy: A retrospective study in Iran.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Azarnia Mina, Sharifi Mehran, Rezaeian Zahra, Arabzadeh Saeedeh, Haghjooy Javanmard Shaghayegh
Аннотация
BACKGROUND: Breast cancer is the most common malignancy among women in Iran and worldwide. Although both neoadjuvant and adjuvant chemotherapies are widely used, their impact on relapse-free survival (RFS) and metastasis-free survival (MFS) in real-world settings remains unclear. This study aimed to compare RFS and MFS between neoadjuvant and adjuvant chemotherapy in breast cancer patients.
METHODS: A retrospective cohort study was conducted on patients who had received adjuvant or neoadjuvant therapy at Seyed Al-Shohada Hospital during July 2016 and July 2020. The cut-off date was July 202. Kaplan-Meier analysis and Cox regression models were used to evaluate RFS and MFS. To address potential confounding by indication due to non-randomized treatment assignment, inverse probability of treatment weighting (IPTW) was applied using propensity scores based on age, tumor grade, and molecular subtype.
RESULTS: Neoadjuvant therapy was significantly associated with increased relapse risk compared to adjuvant therapy in both multivariate (HR = 3.06, P = 0.030) and IPTW-weighted models (HR = 6.10, P = 0.002). No significant difference in MFS was observed between treatment groups. TNBC was identified as the strongest predictor of metastasis (HR = 6.45, P = 0.001). Subtype-specific analyses revealed better outcomes with adjuvant therapy in Luminal A and improved MFS/RFS with neoadjuvant therapy in TNBC.
CONCLUSION: Adjuvant therapy was associated with better local disease control (RFS), while MFS was primarily influenced by tumor subtype. These findings highlighted the importance of subtype-tailored therapeutic strategies and supported the use of causal methods such as IPTW in observational oncology research.
METHODS: A retrospective cohort study was conducted on patients who had received adjuvant or neoadjuvant therapy at Seyed Al-Shohada Hospital during July 2016 and July 2020. The cut-off date was July 202. Kaplan-Meier analysis and Cox regression models were used to evaluate RFS and MFS. To address potential confounding by indication due to non-randomized treatment assignment, inverse probability of treatment weighting (IPTW) was applied using propensity scores based on age, tumor grade, and molecular subtype.
RESULTS: Neoadjuvant therapy was significantly associated with increased relapse risk compared to adjuvant therapy in both multivariate (HR = 3.06, P = 0.030) and IPTW-weighted models (HR = 6.10, P = 0.002). No significant difference in MFS was observed between treatment groups. TNBC was identified as the strongest predictor of metastasis (HR = 6.45, P = 0.001). Subtype-specific analyses revealed better outcomes with adjuvant therapy in Luminal A and improved MFS/RFS with neoadjuvant therapy in TNBC.
CONCLUSION: Adjuvant therapy was associated with better local disease control (RFS), while MFS was primarily influenced by tumor subtype. These findings highlighted the importance of subtype-tailored therapeutic strategies and supported the use of causal methods such as IPTW in observational oncology research.