Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jun 18, 2022
Date Accepted: Oct 18, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Stage-specific Survival in Breast Cancer between Chinese and White Women: An Surveillance, Epidemiology, and End Results Data Analysis
ABSTRACT
Background:
The stage-specific survival according to the 8th breast cancer (BC) American Joint Committee on Cancer (AJCC) pathological prognostic staging (PPS) between Chinese and White American (WA) women remains unclear.
Objective:
To assess the stage-specific survival in BC between Chinese and WA women according to the 8th AJCC PPS.
Methods:
We included Chinese and WA patients with BC diagnosed between 2010 and 2018 from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier method, receiver operating curve (ROC), and multivariate cox proportional hazards models were used for data analysis.
Results:
We included 376,818 patients in this study, including 369,522 WA and 7,296 Chinese. Of these patients, 39.7% migrated from the 7th AJCC anatomical staging (AS) to the PPS (6% upstaged and 33.7% downstaged), and there was statistical significance in upstaging and downstaging rates between WA and Chinese patients (P=0.004). With a median follow-up time of 44 months, the 5-year overall survival and cancer-specific survival (CSS) for the entire group were 87.4% and 95.9%, respectively. The 7th AJCC AS (P<0.001) and the 8th AJCC PPS (P<0.001) could significantly predict the survival outcomes of BC. ROC curve showed that the PPS had a better discriminating ability than the AS [the area under the curve (AUC) 0.769 vs. 0.753, P<0.001]. Similar trends were observed in WA and Chinese patients that the 7th AS and the 8th PPS could also significantly predict the survival and prognosis (WA: P<0.001; Chinese: P<0.001), and the 8th PPS had better discriminating ability compared with the 7th AS both in WA (AUC 0.769 vs. 0.753, P<0.001) and Chinese patients (AUC 0.790 vs. 0.776, P<0.001).
Conclusions:
The 8th PPS has a similar discriminative ability between WA and Chinese BC patients compared with the 7th AS. Therefore, the PPS is still applicable for Chinese patients with BC.
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