Relapse-free survival in Sudanese women with non-metastatic breast cancer

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Relapse-free survival in Sudanese women with non-metastatic breast cancer


JournalGlobal Epidemiology
Article typeJournal research article – Clinical research
Publication date – Sep – 2022
Authors – Hiba Faroug Muddather, Areeg Faggad, Moawia Mohammed Ali Elhassan
KeywordsBreast cancer treatment, Breast neoplasms, Cancer recurrence, Disease-free survival, Low-income countries, Prognostic factors
Open access – Yes
SpecialityGeneral surgery, Surgical oncology
World region Eastern Africa
Country: Sudan
Language – English
Submitted to the One Surgery Index on September 17, 2022 at 8:49 pm
Abstract:

Background
Breast cancer (BC) is the most frequently diagnosed cancer and a major cause of cancer mortality in Sudan. However, there is lack of data related to BC relapse. Therefore, this study was undertaken to estimate the 5-year relapse free survival (RFS) rate and factors related to BC relapse in Sudanese women with non-metastatic BC.

Methods
Data of BC women with BC diagnosed and treated at the National Cancer Institute-University of Gezira during 2012 were retrieved from medical records. The cases were followed-up through hospital records and telephone contact. Survival functions were calculated using Kaplan-Meier method and compared by log-rank test. The prognostic factors were tested using univariate and multivariable Cox regression analyses.

Results
We included 168 women with median age of 45 years (range, 22–83 years). 53.5%of women had stage III at time of diagnosis, whereas 4.2% and 42.3% of women presented with stage I and stage II, respectively. At the end of 5 years follow-up, with median follow-up period of 64 months, 94 (56.0%) women were alive in remission, 11 (6.5%) were alive with BC relapse, 49 (29.2%) were dead, and survival status was unknown in 14 (8.3%) women. Most of the occurred relapses were distant relapses. The 5-year RFS was 59%. The independent predictors of relapse were: larger primary tumor size (HR:1.84, 95% CI: 1.54-5.48, p=0.018); involved axillary lymph nodes with tumour (HR: 2.91, 95% CI: 1.53–7.91, p=0.001); not receiving adjuvant radiotherapy (HR: 2.2, 95% CI: 1.22–3.95, p=0.009); and not receiving hormone therapy (HR: 1.67, 95% CI: 1.01–2.76, p= 0.046).

Conclusion
We found a high risk of BC relapse in our resource-constrained settings. Advanced stages, not receiving adjuvant radiotherapy, and not receiving adjuvant hormone therapy were independent predictors associated with worse 5-year RFS. Therefore, enhancing the early diagnosis of BC and improving timely access to appropriate treatments represent key approaches to achieving better treatment outcomes.

OSI Number – 21757

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