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Titolo:
S-phase fraction combined with other patient and tumor characteristics forthe prognosis of node-negative, estrogen-receptor-positive breast cancer
Autore:
Bryant, J; Fisher, B; Gunduz, N; Costantino, JP; Emir, B;
Indirizzi:
Allegheny Univ Hlth Sci, Pittsburgh, PA 15212 USA Allegheny Univ Hlth SciPittsburgh PA USA 15212 Pittsburgh, PA 15212 USA Univ Pittsburgh, NSABP, Pittsburgh, PA 15213 USA Univ Pittsburgh Pittsburgh PA USA 15213 , NSABP, Pittsburgh, PA 15213 USA
Titolo Testata:
BREAST CANCER RESEARCH AND TREATMENT
fascicolo: 3, volume: 51, anno: 1998,
pagine: 239 - 253
SICI:
0167-6806(1998)51:3<239:SFCWOP>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
TAMOXIFEN; SURVIVAL;
Keywords:
ER-positive breast cancer; heterogeneity of risk; prognostic models; S-phase fraction; smoothing splines;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Fisher, B AlleghenyAUniv Hlth Sci, 4 Allegheny Ctr,Suite 602, Pittsburgh, PA 15212 US Allegheny Univ Hlth Sci 4 Allegheny Ctr,Suite 602 Pittsburgh PAUSA 15212
Citazione:
J. Bryant et al., "S-phase fraction combined with other patient and tumor characteristics forthe prognosis of node-negative, estrogen-receptor-positive breast cancer", BREAST CANC, 51(3), 1998, pp. 239-253

Abstract

Women with estrogen-receptor (ER)-positive breast cancer and no axillary lymph-node involvement are considered to have excellent overall prognosis. However, this population is not homogeneous with regard to risk of recurrence; in fact, some of these patients have a prognosis no better than that of many women with ER-negative tumors or positive axillary nodes. Consequently, better tumor markers and better use of those currently available are needed to distinguish patients who would benefit from more aggressive therapy from those for whom such therapy is unnecessary. A well-defined cohort of over 4000 breast cancer patients from National Surgical Adjuvant Breast and Bowel Project (NSABP) Protocol B-14 who had ER-positive tumors and no axillary lymph-node involvement was analyzed to ascertain the usefulness of tumor cell S-phase fraction for prognosis. The significance of clinical tumor size, patient age at surgery, ER and progesteronereceptor (PgR) expression, and nuclear grade was also explored. Statistical methods based on smoothing splines were used to relate treatment failure and mortality rates to patient and tumor characteristics. Models for 5- and10-year disease-free survival (DFS) and overall survival were developed and summarized. The attenuation of the prognostic importance of covariates over time was investigated. After other characteristics were accounted for, a strong association was found between S-phase fraction and DFS, as well as survival. Tumor size, patient age at surgery, and PgR status were also significantly associated withoutcome. The diversity of risk in the B-14 population was more extreme than is generally recognized. The prognostic capabilities of S-phase, tumor size, and PgR status were sharply attenuated as the time from surgery increased.

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Documento generato il 28/11/20 alle ore 21:17:37