Prognostic role of clinical, pathological and biological characteristics in patients with locally advanced breast cancer

A H Honkoop, P J van Diest, J S de Jong, S C Linn, G Giaccone, K Hoekman, J Wagstaff, H M Pinedo

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Forty-two patients with clinical stage IIIA or IIIB breast cancer were treated with neoadjuvant chemotherapy followed by mastectomy and radiotherapy. The median follow-up was 32 months (range 10-72 months) and the median time to progression was 17 months (range 10-30 months). A multivariate analysis showed that a longer disease-free survival (DFS) was related to more chemotherapy cycles given (P = 0.003), a better pathological response to chemotherapy (P = 0.04) and fewer positive axillary lymph nodes (P = 0.05). A better overall survival (OS) was related to more chemotherapy cycles given (P = 0.03) and better pathological response to chemotherapy (P = 0.04). In patients with residual tumour after neoadjuvant chemotherapy, high levels of staining for Ki-67 was correlated with a worse DFS (P = 0.008). Other biological characteristics, including oestrogen receptor status, microvessel density (CD31 staining), P-glycoprotein (P-gp) staining and nuclear accumulation of p53, were not independent prognostic factors for either DFS or OS. If both P-gp and p53 were expressed, DFS and OS were worse in the uni- and multivariate analysis. The preliminary results of this phase II study suggest that coexpression of P-gp/p53 and a high level of staining for Ki-67 after chemotherapy are associated with a worse prognosis, and that prolonged neoadjuvant chemotherapy and the attainment of a pathological complete remission are important factors in determining outcome for patients with this disease.

Original languageEnglish
Pages (from-to)621-6
Number of pages6
JournalBritish Journal of Cancer
Volume77
Issue number4
Publication statusPublished - Feb 1998

Keywords

  • Adult
  • Analysis of Variance
  • Antineoplastic Combined Chemotherapy Protocols
  • Breast Neoplasms
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Cyclophosphamide
  • Disease-Free Survival
  • Doxorubicin
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Neoplasm Proteins
  • Neoplasm Staging
  • P-Glycoprotein
  • Prognosis
  • Tumor Suppressor Protein p53

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