Influence of the competing risk of death on estimates of disease recurrence in trials of adjuvant endocrine therapy for early-stage breast cancer: A secondary analysis of MA.27, MA.17 and MA.17R.

摘要: Abstract Background Many women diagnosed with early-stage hormone-sensitive breast cancer die of causes other than their cancer. These competing risks can create challenges in analysing and clearly communicating data on risk recurrence or death. Here, we quantify the impact estimates disease benefit from therapy. Patients methods Using MA.27, MA.17 MA.17R trials adjuvant endocrine therapy early cancer, compared Kaplan-Meier (KM) for disease-free survival (DFS) distant recurrence-free (DRFS). Each trial was analysed separately. In KM analyses, participants were censored at time non-breast Competing analyses comprised cumulative incidence functions which death a risk. Results Non-breast deaths observed more often older participants, those lower after longer follow-up. Compared conventional proportion DFS DRFS events risk analyses, this difference increasing over course The absolute treatment similar modestly analyses. Conclusion methods, result experimental Over long horizon, risk methods may be preferable to when estimating future Clinical registration Clinicaltrials.gov ; NCT00003140 , NCT00754845 NCT00066573 .