Flow cytometry in node-positive breast cancer: Cancer and leukemia group B protocol 8869
| Autor: | Timothy E. Kute, Edison Liu, Frederick C. Koerner, Yasmeen Quadri, I. Craig Henderson, Maurice Barcos, Constance Cirrincione, Nora Zbieranski, Ann P. Thor, Hyman B. Muss, Donald A. Berry |
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| Rok vydání: | 1995 |
| Předmět: |
Oncology
medicine.medical_specialty Multivariate analysis medicine.medical_treatment Biophysics Breast Neoplasms S Phase Pathology and Forensic Medicine law.invention Endocrinology Breast cancer Drug Therapy Randomized controlled trial Predictive Value of Tests law Internal medicine medicine Humans skin and connective tissue diseases Survival rate Randomized Controlled Trials as Topic Chemotherapy Univariate analysis Leukemia Ploidies business.industry Cell Cycle Reproducibility of Results Cancer Cell Biology Hematology Flow Cytometry Prognosis medicine.disease Survival Rate Kinetics Predictive value of tests Immunology Female business |
| Zdroj: | Cytometry. 22:297-306 |
| ISSN: | 1097-0320 0196-4763 |
| Popis: | This report describes a companion flow cytometry study (Cancer and Leukemia Group B (CALGB)--8869) using tumors derived from patients enrolled in a large randomized clinical trial (CALGB-8541) performed on 1,572 patients with early stage, node-positive breast cancer. The CALGB initiated an adjuvant breast cancer trial in 1985 to determine if dose intensification (dose of drug per unit time) of chemotherapy was related to relapse-free and overall survival. Patients were randomized by pretreatment clinical variables to one of three different dosage regimens of chemotherapy. Using a tumor enrichment procedure, 442 paraffin-embedded blocks were analyzed by flow cytometry, and S-phase fraction (SPF) was analyzed by three different methods. Ploidy analysis was performed using standard procedures. Tissue from 90% of the patients was suitable for ploidy analysis, whereas only 68% could be assessed for SPF. With a median follow-up time of 80 months, our results show that ploidy status had no clinical utility, whereas high SPF predicted poorer overall survival. The rectangular fit model for SPF was more predictive of outcome than both the area fit model and a computer fit model (modfit) for SPF. In univariate analysis, patients with a low SPF (10%) had a better prognosis than those patients with a high SPF (10%), but they responded equally well to the different treatment regimens. Patients with high SPF (10%) had longer relapse-free and overall survival to high dose chemotherapy compared to low or standard dose chemotherapy. Multivariate analysis indicated that treatment intensity as well as the number of positive nodes, tumor size, steroid receptor status, and c-erb B-2 expression were significant in predicting overall and disease-free survival. The multivariate analysis, however, revealed that SPF was significant in predicting overall but not disease-free survival, but there was no longer any relationship among SPF, dose intensity, and outcome. |
| Databáze: | OpenAIRE |
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