Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Symmans, WF; Peintinger, F; Hatzis, C; Rajan, R; Kuerer, H; Valero, V; Assad, L; Poniecka, A; Hennessy, B; Green, M; Buzdar, AU; Singletary, SE; Hortobagyi, GN; Pusztai, L.
Measurement of residual breast cancer burden to predict survival after neoadjuvant chemotherapy.
J Clin Oncol. 2007; 25(28): 4414-4422.
Doi: 10.1200/JCO.2007.10.6823
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- Co-Autor*innen der Med Uni Graz
- Peintinger Florentia
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- Abstract:
- Purpose To measure residual disease after neoadjuvant chemotherapy in order to improve the prognostic information that can be obtained from evaluating pathologic response. Patients and Methods Pathologic slides and reports were reviewed from 382 patients in two different treatment cohorts: sequential paclitaxel (T) then fluorouracil, doxorubicin, and cyclophosphamide (FAC) in 241 patients; and a single regimen of FAC in 141 patients. Residual cancer burden (RCB) was calculated as a continuous index combining pathologic measurements of primary tumor (size and cellularity) and nodal metastases (number and size) for prediction of distant relapse-free survival (DRFS) in multivariate Cox regression analyses. Results RCB was independently prognostic in a multivariate model that included age, pretreatment clinical stage, hormone receptor status, hormone therapy, and pathologic response (pathologic complete response [pCR] v residual disease [RD]; hazard ratio = 2.50; 95% Cl 1.70 to 3.69; P < .001). Minimal RD (RCB-l) in 17% of patients carried the same prognosis as pCR (RCB-0). Extensive RD (RCB-III) in 13% of patients was associated with poor prognosis, regardless of hormone receptor status, adjuvant hormone therapy, or pathologic American Joint Committee on Cancer stage of residual disease. The generalizability of RCB for prognosis of distant relapse was confirmed in the FAC-treated validation cohort. Conclusion RCB determined from routine pathologic materials represented the distribution of RD, was a significant predictor of DRFS, and can be used to define categories of near-complete response and chemotherapy resistance.
- Find related publications in this database (using NLM MeSH Indexing)
- Antineoplastic Combined Chemotherapy Protocols - therapeutic use
- Axilla -
- Breast Neoplasms - drug therapy Breast Neoplasms - pathology
- Disease-Free Survival -
- Female -
- Humans -
- Lymphatic Metastasis - pathology
- Middle Aged -
- Multivariate Analysis -
- Neoadjuvant Therapy -
- Neoplasm, Residual - pathology
- Predictive Value of Tests -
- Proportional Hazards Models -