ISSN:
1573-7217
Keywords:
breast cancer
;
long term effect
;
primary chemotherapy
;
short term effect
;
weighted logrank tests
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract A potential advantage of primary over adjuvant chemotherapy in breast cancer survival had been proposed on theoretical grounds. In 1994, early results of the S6‐trial comparing primary chemotherapy vs. adjuvant chemotherapy for operable breast cancer in 390 premenopausal patients had shown significant improvement in survival of the primary chemotherapy arm (p=0.04). An updated analysis conducted in 1995 showed the disappearance of this difference between the two arms (p=0.18). In the present analysis, we investigated the potential short and long‐term benefits attributable to primary chemotherapy by applying weighted logrank tests designed to assess specifically these effects. Results were compared to those obtained with the classical logrank test. At a median follow‐up of 105 months, a significant short‐term survival benefit (p=0.02) in favor of the primary chemotherapy has been shown. However, no long‐term survival benefit (p=0.36) could be documented. The classical logrank test had revealed no significant difference (p=0.24) between the two groups but the proportional hazard assumption being rejected (p=0.04), the efficiency of this test can be questioned. Results using the present analysis suggested that primary chemotherapy delayed early death rates, without significantly modifying long‐term event rates. It emphasizes that a short‐term effect which is not necessarily associated with a long‐term benefit may be seen at an early evaluation and disappear later on.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1006339918798
