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Titolo:
Factors predictive of outcome in patients with breast cancer refractory toneoadjuvant chemotherapy
Autore:
Buchholz, TA; Hill, BS; Tucker, SL; Frye, DK; Kuerer, HM; Buzdar, AU; McNeese, MD; Singletary, SE; Ueno, NT; Pusztai, L; Valero, V; Hortobagyi, GN;
Indirizzi:
Univ Texas, MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USAUniv Texas Houston TX USA 77030 Dept Radiat Oncol, Houston, TX 77030 USA Univ Texas, MD Anderson Canc Ctr, Dept Biomath, Houston, TX 77030 USA UnivTexas Houston TX USA 77030 Ctr, Dept Biomath, Houston, TX 77030 USA Univ Texas, MD Anderson Canc Ctr, Dept Breast Med Oncol, Houston, TX 77030USA Univ Texas Houston TX USA 77030 pt Breast Med Oncol, Houston, TX 77030USA Univ Texas, MD Anderson Canc Ctr, Dept Surg Oncol, Houston, TX 77030 USA Univ Texas Houston TX USA 77030 r, Dept Surg Oncol, Houston, TX 77030 USA Univ Texas, MD Anderson Canc Ctr, Dept Blood & Marrow Transplantat, Houston, TX 77030 USA Univ Texas Houston TX USA 77030 arrow Transplantat, Houston, TX 77030 USA
Titolo Testata:
CANCER JOURNAL
fascicolo: 5, volume: 7, anno: 2001,
pagine: 413 - 420
SICI:
1528-9117(200109/10)7:5<413:FPOOIP>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
LYMPH-NODE METASTASES; PRIMARY TUMOR; IN-VIVO; PACLITAXEL; DOCETAXEL; THERAPY; DOXORUBICIN; MANAGEMENT; CARCINOMA; DISEASE;
Keywords:
refractory breast cancer; outcome; neoadjuvant;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Buchholz, TA Univ Texas, MD Anderson Canc Ctr, Dept Radiat Oncol, 1515 Holcombe Blvd,Box 97, Houston, TX 77030 USA Univ Texas 1515 Holcombe Blvd,Box 97 Houston TX USA 77030 USA
Citazione:
T.A. Buchholz et al., "Factors predictive of outcome in patients with breast cancer refractory toneoadjuvant chemotherapy", CANCER J, 7(5), 2001, pp. 413-420

Abstract

PURPOSEThe purpose of this study was to determine the clinical, pathological, andtreatment factors that are predictive of local-regional recurrence and overall survival for patients with breast cancer that is refractory to neoadjuvant chemotherapy. PATIENTS AND METHODSThis study analyzed the data of the 177 breast cancer patients treated on our institutional protocols who had less than a partial response to neoadjuvant chemotherapy. The initial clinical stage of disease was II In 27%, IIIin 69%, and IV (supraclavicular lymph node involvement) in 4%. Surgery wasperformed in 94% of the patients, and 77% of these patients also received adjuvant chemotherapy. RESULTSAfter a median follow-up of 5.2 years, 106 patients experienced disease recurrence, with 98 of these having distant metastases and 45 having local-regional recurrence. The 5- and 10-year overall survivals for the entire group were 56% and 33%, respectively. The factors that were independently associated with a statistically significant poorer overall survival in a Cox regression analysis were pathologically involved lymph nodes after surgery, estrogen receptor-negative disease, and progressive diseaseduring neoadjuvantchemotherapy. The 5-year overall survival for patients with pathologically negative lymph nodes ranged from 84% (estrogen receptor-positive disease) to 75% (estrogen receptor-negative disease), compared with rates for patients with pathologically positive lymph nodes of 66% (estrogen receptor-positive disease) and 40% (estrogen receptor-negative disease). The 5-year survival of patients with progressive disease was only 19%. The 5- and 10-year local-regional recurrence rates for the 177 patients were 27% and 34%, respectively. Significant factors on Cox analysis that predicted for local-regional recurrencewere four or more pathologically involved lymph nodes and estrogen receptor-negative disease. For the 105 patients treated with surgery and postoperative radiation therapy, the 10-year local-regional recurrence rates for thesubgroups with 0, 1, or 2 of these factors were 12%, 25%, and 44%, respectively. CONCLUSIONSFor patients with a poor response to neoadjuvant chemotherapy, conventional treatments achieve reasonable outcomes in those with lymph node-negative disease or estrogen receptor-positive disease. However, more active systemic and local therapies are needed for patients with estrogen receptor-negative disease and positive lymph nodes and for those with clinical evidence ofprogressive disease during neoadjuvant chemotherapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/01/20 alle ore 01:20:36