Abstract P2-09-02: Validation of a Novel Staging System for Disease-Specific Survival in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy

Autor: Jacqueline S. Jeruss, E. A. Mittendorf, Aysegul A. Sahin, Susan L. Tucker, Gabriel N. Hortobagyi, A. M. Gonzalez-Angulo, Aman U. Buzdar, Janice N. Cormier, Lisa A. Newman, A Kolli, K. K. Hunt, Thomas A. Buchholz
Rok vydání: 2010
Předmět:
Zdroj: Cancer Research. 70:P2-09
ISSN: 1538-7445
0008-5472
2003-2005
DOI: 10.1158/0008-5472.sabcs10-p2-09-02
Popis: Purpose We previously described a novel breast cancer staging system for assessing prognosis after neoadjuvant chemotherapy based on pretreatment clinical stage (CS), estrogen receptor status (E), grade (G) and post-treatment pathologic stage (PS). This CPS+EG staging system assigned and summed points for each factor, allowing for better determination of breast cancer-specific survival than CS or PS alone. The current study was undertaken to validate this staging system using internal and external cohorts. Methods We identified 804 patients treated with neoadjuvant chemotherapy at our institution from 2003-2005 who were not part of the original determination of the CPS+EG staging system and an external cohort of 165 patients treated at another institution. Clinicopathologic characteristics, treatment regimens, and patient outcomes were assessed. Outcomes were stratified by CPS+EG score in order to test whether the 5-year disease-specific survival (DSS) in each CPS+EG group was numerically as predicted. Results The 5-year DSS for the internal cohort was 77% (95% CI: 72-82) at a median follow-up of 3.4 years (range, 03-5.9). The 5-year DSS for the external cohort was 86% (95% CI: 7 -91) at a median follow-up of 4.7 years (range, 0.5-10.5). The ability of the CPS+EG score to distinguish outcomes based on good or poor prognosis was confirmed in both the internal and external cohorts. In both cohorts, application of the CPS+EG staging system facilitated more accurate categorization of patients into prognostic subgroups than CS or final PS as defined by the American Joint Committee on Cancer (AJCC) staging system. Disease-Specific Survival Outcomes Based on the CPS+EG Staging System Application of the CPS+EG to all three cohorts combined, demonstrated 5-year DSS ranging from 23% to 99% versus 5-year DSS ranging from 61% to 92% based on presenting CS or 58% to 95% based on post-treatment PS. Conclusion The current study validates the CPS+EG staging system in independent patient cohorts. We recommend that biologic markers and response to treatment be incorporated into revised versions of the AJCC staging system for patients receiving neoadjuvant chemotherapy. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-09-02.
Databáze: OpenAIRE
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