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A prognostic model to predict outcome of patients failing to achieve pathological complete response after anthracycline‐containing neoadjuvant chemotherapy for breast cancer
Author(s) -
Chen Sheng,
Chen CanMing,
Yu KeDa,
Yang WenTao,
Shao ZhiMing
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22140
Subject(s) - medicine , anthracycline , breast cancer , oncology , chemotherapy , stage (stratigraphy) , lymph node , pathological , multivariate analysis , cathepsin d , neoadjuvant therapy , epirubicin , cancer , paleontology , biochemistry , chemistry , biology , enzyme
Background The aim of this study was to evaluate factors that could possibly affect the outcome of patients failing to achieve pathological complete response (pCR) after anthracycline‐containing neoadjuvant chemotherapy (NCT) for breast cancer, and built a prognostic model to predict patients' outcome. Patients and Methods Data from 199 stage II–III breast cancer patients who failed to achieve pCR after NCT were used. Variables at baseline and at surgery (age, menopausal status, tumour size, grade, histotype, node status, vascular invasion, ER, PR, HER‐2, Cathepsin D, P53, Topo‐IIα, Nm‐23, Bcl‐2, BAX, MDR, GSTN, PS2, P27, Cyclin D1 and Ki‐67) were investigated. Results Tumour marker Ki‐67, Cathepsin D status and number of positive lymph nodes at surgery were significant prognostic factors in multivariate analysis for both DFS and OS. According to our prognostic model, the 5‐year DFS rates in low, intermediate‐low, intermediate‐high and high‐risk groups were 94%, 65%, 43% and 28%, respectively (log‐rank test P < 0.001). The 5‐year OS rates in these four groups were 94%, 84%, 66% and 34%, respectively (log‐rank test P < 0.001). Conclusion Our prognostic model could easily discriminate patients with different risks of experiencing an event or death, which could allow physicians to tailor treatment strategies specifically and individually. J. Surg. Oncol. 2012; 105:577–585. © 2011 Wiley Periodicals, Inc.