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Cancer Survival Analysis01:21

Cancer Survival Analysis

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Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
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  1. Home
  3. Prioritizing Breast Cancer Surgeries: Insights From The Kronos Score.
  1. Home
  3. Prioritizing Breast Cancer Surgeries: Insights From The Kronos Score.

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Prioritizing breast cancer surgeries: insights from the KRONOS SCORE.

Lucía Navarro1,2,3, Luis Perez-Bartivas1,2,3, David Ponferrada1,2,3

  • 1Medical Oncology Department, University Hospital Reina Sofia, Cordoba, Spain.

Frontiers in Oncology
|February 5, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Prolonged time to surgery (TTS) for breast cancer (BC) patients showed a trend toward increased lymph node involvement, especially in high-grade tumors. A new KRONOS SCORE aids in prioritizing patients for timely surgical intervention.

Keywords:
breast cancerclinical outcomeslymph node metastasisneoplasm gradingnode stagingtime to surgery

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Area of Science:

  • Oncology
  • Surgical Quality Improvement
  • Cancer Care Delivery

Background:

  • Time to surgery (TTS) is a critical quality metric in breast cancer (BC) care.
  • Guidelines recommend waiting up to four weeks, but this is often exceeded, potentially affecting outcomes.
  • The COVID-19 pandemic underscored the need to evaluate surgical urgency in BC treatment.

Purpose of the Study:

  • To investigate the association between TTS and clinical outcomes in breast cancer patients.
  • To determine how TTS influences final tumor stage and lymph node involvement.
  • To develop and validate a prognostic score (KRONOS SCORE) for surgical prioritization.

Main Methods:

  • Retrospective cohort study of 924 women with cT1-T3 breast cancer without initial lymph node involvement (2014-2023).
  • Preoperative staging via mammography/ultrasound; postoperative staging via pathology.
  • Statistical analyses included chi-square, Wilcoxon tests, and logistic regression; KRONOS SCORE developed and internally validated.

    • Main Results:

    • No significant difference in tumor size changes based on TTS (≤8 weeks vs. >8 weeks).
    • Lymph node involvement increased from 23.8% to 26.5% with TTS >8 weeks, significantly higher in poorly differentiated (G3) tumors.
    • The validated KRONOS SCORE (age, grade, size) predicted higher risk of lymph node involvement.

    Conclusions:

    • While TTS did not significantly impact most parameters, a trend of increased lymph node involvement was observed with longer waits, particularly in G3 tumors.
    • The KRONOS SCORE can assist in risk stratification and prioritizing surgical patients.
    • Further prospective, multicenter studies are required to validate findings and the KRONOS SCORE.