Evaluating the Fragility of Long-Term Outcomes for Neoadjuvant versus Adjuvant Chemotherapy Prescription in Early Breast Cancer: Pooled Data from 10 Randomised Clinical Trials

Figures & data

Figure 1 Illustration of how the alteration of two events results in alteration of statistical significance, demonstrating the concept of “Fragility”.

Figure 2 PRISMA flowchart illustrating of the systematic search process.

Table 1 Data from the 10 Included Prospective Randomised Clinical Trials

Author	Year	Study Design	Country	Follow Up	N	N NAC	N AC	Risk of Bias
Taucher^Citation16	2008	RCT	Austria	9 years	398	203	195	Some
Wolmark^Citation17	2001	RCT	USA	9 years	1493	751	742	Low
van der Hage^Citation18	2001	RCT	Netherlands	5 years	698	350	348	Low
Powles^Citation19	1995	RCT	UK	2 years	212	105	107	Some
Gazet^Citation20	2001	RCT	UK	5 years	210	100	110	Some
Gianni^Citation21	2009	RCT	Italy	7 years	1324	448	876	Low
Mauriac^Citation22	1999	RCT	France	10 years	278	134	144	Some
Scholl^Citation23	1991	RCT	France	5 years	181	95	86	Some
Danforth Jr^Citation24	2003	RCT	USA	9 years	53	26	27	High
Ragaz^Citation25	1997	RCT	Canada	–	81	42	39	High

Abbreviations: N, number; NAC, neoadjuvant chemotherapy; AC, adjuvant chemotherapy; RCT, randomised clinical trial; USA, United States of America; UK, United Kingdom.

Table 2 Surgical, Oncological, and Survival Data from the 10 Included Prospective Randomised Clinical Trials

Author	Year	N	N NAC	N AC	BCS NAC	BCS AC	LR NAC	LR AC	DR NAC	DR AC	BCSM NAC	BCSM AC	OS NAC	OS AC
Taucher^Citation16	2008	398	203	195	133	116	27	16	62	44	39	27	46	32
Wolmark^Citation17	2001	1493	751	742	503	448	124	108	256	264	256	264	325	319
van der Hage^Citation18	2001	698	350	348	77	74	33	30	139	122	99	89	104	96
Powles^Citation19	1995	212	105	107	88	71	7	8	37	41	34	37	44	44
Gazet^Citation20	2001	210	100	110	65	96	7	8	19	17	19	18	26	22
Gianni^Citation21	2009	1324	448	876	282	298	20	35	90	171	39	27	72	145
Mauriac^Citation22	1999	278	134	144	84		39	18	66	65	60	60	72	67
Scholl^Citation23	1991	181	95	86	73	55	75	50	97	96	77	77	84	87
Danforth Jr^Citation24	2003	53	26	27	11	11	3	2	5	7	2	4	3	6
Ragaz^Citation25	1997	81	42	39	–	–	10	3	20	20	19	19	25	21
–	–	4928	2254	2674	1316	1169	345	278	791	847	644	622	801	839
Percentage	–	100.0	45.7	54.3	59.5	43.7	15.3	10.4	35.1	31.7	28.6	23.3	35.5	31.4

Abbreviations: N, number; NAC, neoadjuvant chemotherapy; AC, adjuvant chemotherapy; BCS, breast conservation surgery; LR, local recurrence; DR, distant recurrence; BCSM, breast cancer specific mortality.

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