Late effects of adjuvant chemotherapy adumbrate dormancy complexity in breast cancer
| Autor: | Martine Piccart, Christos Sotiriou, Mike Retsky, Elia Biganzoli, Christine Desmedt, Romano Demicheli |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Adjuvant chemotherapy law.invention 0302 clinical medicine Breast cancer Belgium Randomized controlled trial law CYCLOPHOSPHAMIDE Secondary Prevention Medicine 030212 general & internal medicine Randomized Controlled Trials as Topic Early breast cancer Dormancy states Hazard ratio Obstetrics & Gynecology General Medicine lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens METHOTREXATE INSIGHTS Enseignement des sciences bio-médicales et agricoles Distant metastasis dynamics Adjuvant chemotherapy effects Italy Chemotherapy Adjuvant Neoplasm Micrometastasis Lymphatic Metastasis 030220 oncology & carcinogenesis TUMOR DORMANCY GROWTH Female Original Article Primary breast cancer Life Sciences & Biomedicine medicine.medical_specialty DOXORUBICIN Breast Neoplasms lcsh:RC254-282 03 medical and health sciences RECURRENCE RISK Internal medicine Surgical removal MASTECTOMY Humans Proportional Hazards Models Science & Technology business.industry Médecine pathologie humaine medicine.disease Surgery effects FLUOROURACIL Cancérologie Premenopause Dormancy Surgery business FOLLOW-UP |
| Zdroj: | The Breast : official journal of the European Society of Mastology Breast, Vol 52, Iss, Pp 64-70 (2020) Breast, 52 |
| Popis: | Background: Dormant avascular micrometastases and single, or small groups of, non-proliferating cells are currently assumed to explain the multipeak dynamics of distant metastases (DM) following primary breast cancer surgical removal. Methods: The hazard rate pattern for DM was analysed in 1518 premenopausal node-positive patients, enrolled in a series of randomized clinical trials on early breast cancer, which were carried out in Italy and Belgium. Patients underwent surgery alone (n = 397) or surgery plus adjuvant chemotherapy (n = 1121) and the minimal follow up was 15 years. Results: The DM hazard rate for patients undergoing surgery alone displayed two early sharp peaks at 9 and 33 months, a wide intermediate one spanning from about 50 to 90 months and a late peak at 115–120 months. Adjuvant chemotherapy was associated with a prominent reduction of the two early peaks leaving a residual one at about 18 months and a reduction of the intermediate peak leaving two small peaks at about 50 and 80 months. The late peak remained unchanged. Conclusions: Present results reveal the ability of adjuvant chemotherapy to reduce not only the rate of early relapses, but also the rate of intermediate relapses at about the sixth year of follow up. Adjuvant chemotherapy is not impacting on the development of metastases underlying the late peak detected at the tenth year. These findings suggest the existence of a previously unknown dormancy state that, at the primary tumour surgical removal, results in evolving chemo-sensitive metastatic processes, and, moreover, of a later chemo-refractory dormancy state. SCOPUS: ar.j info:eu-repo/semantics/published |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|