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Outcomes in Nonmetastatic Hormone Receptor–Positive HER2-Negative Pure Mucinous Breast Cancer: A Multicenter Cohort Study

Ryan Ying Cong Tan, Whee Sze Ong, Kyung-Hun Lee, Seri Park, Jabed Iqbal, Yeon Hee Park, Jeong Eon Lee, Jong Han Yu, Ching-Hung Lin, Yen-Shen Lu, Makiko Ono, Takayuki Ueno, Yoichi Naito, Tatsuya Onishi, Geok-Hoon Lim, Su-Ming Tan, Han-Byoel Lee, Jiwon Koh, Wonshik Han, Seock-Ah Im, Veronique Kiak Mien Tan, Nitar Phyu, Fuh-Yong Wong, Puay Hoon Tan, and Yoon-Sim Yap

Background: Although considered a favorable subtype, pure mucinous breast cancer (PMBC) can recur, and evidence for adjuvant therapy is limited. We aimed to compare outcomes of nonmetastatic PMBC with invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) to address these uncertainties. Methods: Individual patient-level data from 6 centers on stage I–III hormone receptor–positive and HER2-negative PMBC, IDC, and ILC were used to analyze recurrence-free interval (RFI), recurrence-free survival (RFS), and overall survival (OS), and to identify prognostic factors for PMBC. Results: Data from 20,684 IDC cases, 1,475 ILC cases, and 943 PMBC cases were used. Median follow-up was 6.6 years. Five-year RFI, RFS, and OS for PMBC were 96.1%, 94.9%, and 98.1%, respectively. On multivariable Cox regression, PMBC demonstrated superior RFI (hazard ratio [HR], 0.59; 95% CI, 0.43–0.80), RFS (HR, 0.70; 95% CI, 0.56–0.89), and OS (HR, 0.71; 95% CI, 0.53–0.96) compared with IDC. ILC showed comparable outcomes to IDC. Fewer than half (48.7%) of recurrences in PMBC were distant, which was a lower rate than for IDC (67.3%) and ILC (80.6%). In contrast to RFI, RFS events were driven more by non–breast cancer deaths in older patients. Significant prognostic factors for RFI among PMBC included positive lymph node(s) (HR, 2.42; 95% CI, 1.08–5.40), radiotherapy (HR, 0.44; 95% CI, 0.23–0.85), and endocrine therapy (HR, 0.25; 95% CI, 0.09–0.70). No differential chemotherapy associations with outcomes were detected across PMBC subgroups by nodal stage, tumor size, and age. A separate SEER database analysis also did not find any association of improved survival with adjuvant chemotherapy in these subgroups. Conclusions: Compared with IDC, PMBC demonstrated superior RFI, RFS, and OS. Lymph node negativity, adjuvant radiotherapy, and endocrine therapy were associated with superior RFI. Adjuvant chemotherapy was not associated with better outcomes.

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BPI21-009: Survival Benefit of Adjuvant Chemotherapy in Pulmonary Carcinoid: A Systematic Review

Philip Sobash and Nagla Abdel Karim

atypical disease and metastatic disease. Aim of the study is to explore the benefit of adjuvant therapy for thoracic carcinoid tumors. Methods: A literature review was conducted through PubMed in accordance with PRISMA guidelines to identify studies

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HSR22-125: Quality of Gastrointestinal Surgical Oncology Care According to Insurance Status

Baylee F. Bakkila, Daniel Kerekes, Caroline H. Johnson, and Sajid A. Khan

, adequate lymphadenectomies as per National Comprehensive Cancer Network guidelines and use of adjuvant therapy. Multivariable logistic regressions were fit to determine differences in quality of care by insurance and when controlling for covariates (sex

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HSR23-106: Real-World Study of Disease-Free Survival and Associated Patient Characteristics in Early-Stage Non–Small Cell Lung Cancer (NSCLC): A Retrospective Observational Study

Anne Shah, Jon Apple, Andrew J. Belli, Anna Barcellos, Eric Hansen, Laura L. Fernandes, and Ching-Kun Wang

48.5 months for the EGFRm negative group (rwDFS event rate: 46.3%) and unknown EGFRm status (rwDFS event rate: 49.7%), respectively. After adjustment for key patient covariates; disease stage and adjuvant therapy status were significantly associated

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Updates

of capecitabine + oxaliplatin was added as an option in adjuvant therapy with a category 2A designation. Footnote “j” was clarified by adding “exclusive of those cancers that are MSI-H” to grade 3-4. Surveillance Chest

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Localized Colon Cancer, Version 3.2013

Al B. Benson III, Tanios Bekaii-Saab, Emily Chan, Yi-Jen Chen, Michael A. Choti, Harry S. Cooper, Paul F. Engstrom, Peter C. Enzinger, Marwan G. Fakih, Moon J. Fenton, Charles S. Fuchs, Jean L. Grem, Steven Hunt, Ahmed Kamel, Lucille A. Leong, Edward Lin, Kilian Salerno May, Mary F. Mulcahy, Kate Murphy, Eric Rohren, David P. Ryan, Leonard Saltz, Sunil Sharma, David Shibata, John M. Skibber, William Small Jr, Constantinos T. Sofocleous, Alan P. Venook, Christopher G. Willett, Kristina M. Gregory, and Deborah A. Freedman-Cass

rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. Adjuvant Therapy for Stage II Disease The panel discussed the impact of adjuvant chemotherapy on

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Oncology Research Program

scientific peer-review process and are overseen by the ORP. An NCCN study funded through the grant mechanism is highlighted below. Randomized Phase II Study Comparing Concise (3 Months) Versus Prolonged (2 Years) Afatinib as Adjuvant Therapy for

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Predictors and Temporal Trends of Adjuvant Aromatase Inhibitor Use in Breast Cancer

Tiffany H. Svahn, Joyce C. Niland, Robert W. Carlson, Melissa E. Hughes, Rebecca A. Ottesen, Richard L. Theriault, Stephen B. Edge, Anne F. Schott, Michael A. Bookman, and Jane C. Weeks

. 5 Coates AS Keshaviah A Thurlimann B . Five years of letrozole compared with tamoxifen as initial adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer: update of study BIG 1-98 . J Clin Oncol 2007 ; 25 : 486

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Quality Improvement Project: Opportunities for Improvement

Nora M. Hansen, Sally Anne Scherer, and Seema Khan

of 60 cases, care was nonconcordant in 8. Among those cases, 1 patient was advised to have chemotherapy but refused; another patient’s record did not document a recommendation for adjuvant therapy; and 5 patients received treatment but not within the

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Active Systemic Treatment of Pancreatic Cancer

Margaret Tempero

margin,” she said. Dr. Tempero briefly reviewed some of the representative adjuvant therapy clinical trials conducted in pancreatic cancer, focusing primarily on the relatively recent phase III ESPAC-4 trial of gemcitabine/capecitabine 1 and the