Prognostic indices predictive of short-term disease-free survival of breast carcinoma patients receiving primary surgical treatment in Sri Lanka.

Autor: Wijesinghe HD; Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka., Thuvarakan P; Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka., Samarasekera A; Department of Pathology, National Hospital of Sri Lanka, Colombo, Sri Lanka., S Lokuhetty MD; Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Jazyk: angličtina
Zdroj: Indian journal of pathology & microbiology [Indian J Pathol Microbiol] 2018 Oct-Dec; Vol. 61 (4), pp. 505-509.
DOI: 10.4103/IJPM.IJPM_321_17
Abstrakt: Background: Breast carcinoma (BCa) is the commonest malignancy among women worldwide and in Sri Lanka. Several prognostic indices are described for BCa.
Aims: To assess clinicopathological features and prognostic indices derived from routine clinical, histopathological and immunohistochemical (IHC) data, in a cohort of patients undergoing primary surgery for BCa and to determine their prognostic impact on short-term disease free survival.
Setting and Design: : This is a bidirectional cohort study of 208 women undergoing primary surgery for BCa at the National Hospital of Sri Lanka, from 2012-2014, excluding post-neoadjuvant chemotherapy cases.
Material and Methods: Clinical details, tumor size and nodal status were obtained from histopathology reports. Histopathology and estrogen/progesterone receptor and HER2 status were reviewed. Molecular subtype based on IHC was determined. Nodal ratio (number of positive nodes/total number retrieved) and Nottingham prognostic index were calculated. Follow up information was obtained by patient interviews and record review.
Statistical Analysis: Data was analyzed by univariate and multivariate Cox regression using SPSS19.0.
Results: Mean follow-up duration was 27.16 months (0.5-52 months, s = 9.35 months). 174 (82.9%) remained disease free with 19 (9%) deaths. Thirteen (6.2%) survived with metastasis and 4 (1.9%) with recurrences. On univariate Cox regression, tumor, nodal and TNM stages, nodal ratio and lymphovascular invasion (LVI) were predictive of disease free survival (DFS) (P = 0.001, P = 0.021, P = 0.022, P = 0.002, P = 0.018). On multivariate analysis TNM stage and LVI were predictive of DFS.
Conclusion: TNM stage and LVI were the most important predictors of short-term disease free survival in this study population, confirming that early detection of BCa at a lower stage has a significant impact on short-term outcomes.
Competing Interests: There is no conflict of interest
Databáze: MEDLINE
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