Medizinische Universität Graz - Research portal
Selected Publication:
Mischitz, N.
Residual Cancer Burden as a prognostic factor in breast cancer patients considering the outcome, different subtypes and dose-density of the neoadjuvant therapy
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 42
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- Authors Med Uni Graz:
- Advisor:
- Dandachi Nadia
- Dengler Michael
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- Abstract:
- Background: For breast cancer patients who have received neoadjuvant chemotherapy, the residual cancer burden (RCB) score emerges as a promising prognostic marker with clinical relevance. In this study, the RCB score was independently evaluated as a prognostic marker in an expanded cohort of patients. As an exploratory endpoint, a potential association between the RCB score and dose reduction of neoadjuvant chemotherapy was also analyzed. Material and Methods: In this retrospective study, follow-up data on recurrence-free survival (RFS), distant disease-free survival (DDFS), and overall survival (OS) of 367 breast cancer patients treated at the Department of Oncology, University Hospital of Graz, Austria, were evaluated. In order to determine a possible interaction between dose reduction of neoadjuvant chemotherapy and the RCB score, standardized cumulative doses of anthracyclines and taxanes were calculated. Results: Regardless of breast cancer subtype, a higher RCB score was associated with worse clinical outcome (HR for RFS = 1.60, 95% CI 1.33-1.93, p < 0.0001; HR for DDFS = 1.70, 95% CI 1.39-2.05, p < 0.0001; HR for OS = 1.67, 95% CI 1.34-2.08, p < 0.0001). During the 5-year observation period, there was no difference in clinical outcome between RCB scores 0 and 1. 49.1% of all patients (n=180) received a dose reduction. This study found a significant association between a higher RCB score and a reduction in chemotherapy dose (interaction p-value 0.042). Conclusion: The validity of the RCB score as an independent prognostic marker was confirmed in this retrospective study. Furthermore, reducing the dose of neoadjuvant chemotherapy was associated with higher RCB scores, a finding with important implications for clinical work.