| Autor: |
Curé, Hervé, Amat, Sophie, Penault-Llorca, Frédérique, Bouëdec, Guillaume, Ferrière, Jean-Pierre, Mouret-Reynier, Marie-Ange, Kwiatkowski, Fabrice, Feillel, Viviane, Dauplat, Jacques, Chollet, Philippe |
| Zdroj: |
Breast Cancer Research & Treatment; Nov2002, Vol. 76 Issue 1, p37-45, 9p |
| Abstrakt: |
The purpose of this retrospective study was to evaluate the influence of axillary disease on patients' survival after neoadjuvant chemotherapy and to assess patient and tumor characteristics associated with post-chemotherapy axillary involvement. After six induction cycles, 277 patients with operable breast cancer (stage II–III) underwent surgery with axillary dissection, followed by radiotherapy ( n = 267) or additional chemotherapy ( n = 63) and adjuvant tamoxifen therapy ( n = 138). At a median follow-up of 8.5 years, overall survival (OS) and disease-free survival (DFS) were analyzed as a function of node involvement. The differences in OS and DFS according to the number of positive nodes were highly statistically significant with a decreased survival associated with the increasing number of nodes ( p = 5 × 10−6 and 9 × 10−7, respectively). Upon multivariate analysis, the node number after chemotherapy appeared as the most significant prognostic factor ( p = 7 × 10−4 for OS and p = 3 × 10−5 for DFS). All the other classical prognostic factors were insignificant, except post-chemotherapy Scarff–Bloom–Richardson (SBR) grading for OS ( p = 8 × 10−4) and adjuvant hormonotherapy for DFS ( p = 1 × 10−2). Although constituting a different parameter from primary surgery data, the number of positive nodes after chemotherapy could still remain a valuable prognostic factor at secondary surgery, raising the question for high risk patients of a second non-cross-resistant adjuvant regimen, or high dose chemotherapy with peripheral blood stem cells support. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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