Molecular Subtypes and Prognostic Factors among Premenopausal and Postmenopausal Thai Women with Invasive Breast Cancer: 15 Years Follow-up Data

Background and Purpose: This study focused on molecular subtypes and prognostic factors for survival of preand post-menopausal breast cancer patients. Methods: A retrospective cohort study was performed on 523 patients with invasive carcinoma of the breast treated at Ubon Ratchathani Cancer Hospital,Thailand from 2002 to 2016. Patient characteristics were collected based on a systematic chart audit from medical records. Prognostic factors were performed by observe survival analysis. A Cox regression model was used to calculate hazard ratios of death, taking into account the age and menopause status, molecular subtype, stage of disease, histological grade, lymphatic and vascular invasion, resection margin, hormone receptor expression, and treatment modality. Results: The median time from the diagnosis of invasive breast cancer to the last follow-up or death was 10.2 [95% CI = 9.28-11.95] years in premenopausal women, and 7.4 [95% CI = 6.48-8.44] years in postmenopausal cases. The overall survival estimates at 5 and 10 years for younger woman of 71.2% and 51.8% respectively, appeared slightly better than the 68.3% and 40.9% for postmenopausal women [HRadj = 1.27, 95% CI =0.99-1.63]. In the multivariate analysis, 3 prognostic indicators significantly predicted a worse overall survival in premenopausal patients, triple negative subtype [HRadj = 6.03, 95% CI = 1.94-18.74], HER2-enriched status [HRadj = 4.11, 95% CI = 1.59-10.65] and stage III [HRadj = 2.73, 95% CI = 1.10-6.79]. Statistically significant increased risk of death in postmenopausal patients was noted for only chemotherapy after mastectomy [HRadj = 8.76, 95% CI = 2.88-26.61], and for a Luminal B status [HRadj = 3.55, 95% CI = 1.47-8.53]. Conclusion: Postmenopausal women with invasive breast cancer experience a significantly shorter survival than do their premenopausal counterparts. The predictors of worse overall survival were molecular subtype, stage of disease and type of treatment administered.

Survival of patients with advanced non-small-cell lung cancer at Ubon Ratchathani Cancer Center, Thailand.

This survival analysis was conducted at Ubon Ratchathani Cancer Center to determine the prognostic factors for survival of patients with stage IIIA, stage IIIB, and stage IV non-small-cell lung cancer (NSCLC) patients treated at the center between 1997-2001. The study sample included 210 patients with non-small-cell lung cancer. Diagnosis and staging were defined employing the TNM system. The majority of lung cancer patients were smokers (66.7%), lived in Ubon Ratchathani Province (40.0%), male (77.6%), and agriculturalists (74.8%). Seventy-seven percent of patients died within five years, 19.5% were lost to follow-up and 2.9% were still alive in 2003. The estimated median survival time was 6.3 months (95% CI 5.4-7.3); the median survival times for stages IIIA, IIIB, and IV were 16.3, 7.0, and 4.5 months, respectively. The overall 1-, 2- and 3-year survival rates of NSCLC were 28.9, 7.9, and 3.3, respectively. The differences in survival of patients in the various stages of the disease were statistically significant (p < 0.0001), adjusted for age and sex. Treatment with combination methods and at an early stage in the disease were associated with significant prolongation of survival. For stage IIIA, the estimated median survival times by treatment with chemotherapy was 7.0 months, radiotherapy was 16.0 months, surgery and others 16.3 months, and chemotherapy plus radiotherapy was 19.5 months. However, only chemotherapy versus surgery and others was significantly different (p = 0.0307). The median survival times for stage IIIB patients treated with chemotherapy, radiotherapy, surgery and others, chemotherapy and radiotherapy, and supportive treatment were 7.0, 7.0, 9.0, 14.7, and 3.0 months, respectively. The differences between surgery and others versus supportive treatment, chemotherapy and radiotherapy versus supportive treatment were significantly different (p = 0.0392, p = 0.0433, respectively). For stage IV, the median survival times for patients treated with chemotherapy, radiotherapy, chemotherapy and radiotherapy, and supportive treatment were 5.0, 4.3, 6.5, and 1.0 months, respectively. The differences between chemotherapy, radiotherapy, chemotherapy and radiotherapy versus supportive treatment, all were significantly different (p = 0.0020, p < 0.0001, p < 0.0001, respectively). The 2-year survival rates for stages IIIA, IIIB, and IV were 16.0, 4.1, and 2.2%, respectively. The results of the study show that stage IIIA has the longest survival time. They also show that appropriate treatment is a significant factor in improving the survival of lung cancer patients.