Tumorzelldissemination unter neoadjuvanter Chemotherapie bei Patientinnen mit primärem Mammakarzinom
| Autor: | B. Schauf, G. Bastert, EF Solomayer, Tanja Fehm, D. Wallwiener, G. Meyberg, I. J. Diel |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Oncology
medicine.medical_specialty Chemotherapy Cyclophosphamide business.industry medicine.medical_treatment Mammary gland Obstetrics and Gynecology medicine.disease Nitrogen mustard Surgery chemistry.chemical_compound medicine.anatomical_structure Breast cancer chemistry Internal medicine Maternity and Midwifery medicine Bone marrow business Neoadjuvant therapy medicine.drug Epirubicin |
| Zdroj: | Geburtshilfe und Frauenheilkunde. 63:1267-1273 |
| ISSN: | 1438-8804 0016-5751 |
| Popis: | Purpose: Neoadjuvant chemotherapy (pCHT) is an established method to reduce tumor size (downstaging) in breast cancer patients before performing breast conserving therapy. The consequences of pCHT on tumor cell dissemination (TCD) in these patients are not known. The aim of this study was to evaluate tumor cell dissemination before and after pCHT in breast cancer patients. In addition, the prognostic value of TCD after pCHT was studied. Patients and Methods: 140 women with non-inflammatory, locally advanced breast cancer (tumor size > 3 cm and an unfavorable relation between breast and tumor size) received neoadjuvant chemotherapy with Epirubicin/Cyclophosphamide (90/ 600 mg/m 2 every 3 weeks for 4 cycles). In all patients bilateral aspiration of bone marrow was performed at the time of surgery (after neoadjuvant chemotherapy). In 42 of the 140 patients additional bone marrow aspirations were taken before neoadjuvant chemotherapy. Results: 68 of 140(49%) breast cancer patients had disseminated tumor cells (TCD) after neoadjuvant chemotherapy. TCD was an independent prognostic factor for disease free intervals (p=0.022, RR=2.63) and overall survival (p=0.032, RR=2.23). 20 of 42 patients had disseminated tumor cells before and after neoadjuvant chemotherapy. In contrast, 18 patients had no tumor cell dissemination during neoadjuvant treatment. Four patients had a change of their bone marrow status. Conclusion: Our results demonstrate that TCD is not influenced by neoadjuvant chemotherapy and remains an independent prognostic factor after pCHT. However, future studies will need to investigate whether neoadjuvant therapy changes the metastatic behaviour of TCD. |
| Databáze: | OpenAIRE |
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