Prognostic role of clinical, pathological and biological characteristics in patients with locally advanced breast cancer

A. H. Honkoop, P. J. Van Diest, J. S. De Jong, S. C. Linn, G. Giaccone, K. Hoekman, J. Wagstaff, H. M. Pinedo

Research output: Contribution to journalArticle

Abstract

Forty-two patients with clinical stage IIIA or IIIB breast cancer were treated with neoadjuvant chemotherapy followed by mastectomy and radiotherapy. The median follow-up was 32 months (range 10-72 months) and the median time to progression was 17 months (range 10-30 months). A multivariate analysis showed that a longer disease-free survival (DFS) was related to more chemotherapy cycles given (P = 0.003), a better pathological response to chemotherapy (P = 0.04) and fewer positive axillary lymph nodes (P = 0.05). A better overall survival (OS) was related to more chemotherapy cycles given (P = 0.03) and better pathological response to chemotherapy (P= 0.04). In patients with residual tumour after neoadjuvant chemotherapy, high levels of staining for Ki-67 was correlated with a worse DFS (P = 0.008). Other biological characteristics, including oestrogen receptor status, microvessel density (CD31 staining), P-glycoprotein (P-gp) staining and nuclear accumulation of p53, were not independent prognostic factors for either DFS or OS. If both P-gp and p53 were expressed, DFS and OS were worse in the uni- and multivariate analysis. The preliminary results of this phase II study suggest that coexpression of P-gp/p53 and a high level of staining for Ki-67 after chemotherapy are associated with a worse prognosis, and that prolonged neoadjuvant chemotherapy and the attainment of a pathological complete remission are important factors in determining outcome for patients with this disease.

Original languageEnglish (US)
Pages (from-to)621-626
Number of pages6
JournalBritish Journal of Cancer
Volume77
Issue number4
StatePublished - 1998
Externally publishedYes

Keywords

  • Locally advanced breast cancer
  • Neoadjuvant chemotherapy
  • Prognostic factor

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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  • Cite this

    Honkoop, A. H., Van Diest, P. J., De Jong, J. S., Linn, S. C., Giaccone, G., Hoekman, K., Wagstaff, J., & Pinedo, H. M. (1998). Prognostic role of clinical, pathological and biological characteristics in patients with locally advanced breast cancer. British Journal of Cancer, 77(4), 621-626.