title: Survival Outcome of Combined GnRH Agonist and Tamoxifen Is Comparable to That of Sequential Adriamycin and Cyclophosphamide Chemotherapy Plus Tamoxifen in Premenopausal Patients with Lymph-Node-Negative, Hormone-Responsive, HER2-Negative, T1-T2 Breast Cancer.
abstract: OBJECTIVE
  The purpose of this study was to compare treatment outcomes between combined gonadotropin-releasing hormone agonist and tamoxifen (GnRHa+T) and sequential adriamycin and cyclophosphamide chemotherapy and tamoxifen (AC->T) in premenopausal patients with hormone-responsive, lymph-node-negative breast cancer.
  
  
  METHODS
  In total, 994 premenopausal women with T1-T2, lymph-node-negative, hormone-receptor-positive, HER2-negative breast cancer between January 2003 and December 2008 were included in this retrospective cohort study. GnRHa+T and AC->T were administered to 608 patients (61.2%) and 386 patients (38.8%), respectively. Propensity score matching and inverse probability weighting were applied to the original cohort, and 260 patients for each treatment arm were included in the final analysis. Recurrence-free, cancer-specific, and overall survival was compared between the two treatment groups.
  
  
  RESULTS
  A total of 994 patients were followed up for a median of 7.4 years (range, 0.5 to 11.4 years). The 5-year follow-up rate was 98.7%, and 13 patients were lost to follow-up. In propensity-matched cohorts (n=520), there was no difference in recurrence-free, cancer-specific, and overall survival rates between the two treatment groups (p=0.306, p=0.212, and p=0.102, respectively), and this was maintained after applying inverse probability weighting.
  
  
  CONCLUSIONS
  GnRHa+T is a reasonable alternative to AC->T in patients with premenopausal, hormone-responsive, HER2-negative, lymph-node-negative, T1-T2 breast cancer.
authors.affiliation: Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Guiyun
authors.initials: G
authors.lastname: Sohn
authors.affiliation: Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Hee Jeong
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Son
authors.affiliation: Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Beom Seok
authors.initials: BS
authors.lastname: Ko
authors.affiliation: Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Yura
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sae Byul
authors.initials: SB
authors.lastname: Lee
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seunghee
authors.initials: S
authors.lastname: Baek
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage* / Q000819:agonists; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000819:agonists; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D017697:Premenopause; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D013629:Tamoxifen / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D003520:Cyclophosphamide; D004317:Doxorubicin; D007987:Gonadotropin-Releasing Hormone; D018719:Erb-b2 Receptor Tyrosine Kinases; D013629:Tamoxifen; C508053:ERBB2 protein, human
keywords: Breast neoplasms; Chemotherapy; Drug therapy; Premenopause; Tamoxifen