Adverse prognostic value of peritumoral vascular invasion: is it abrogated by adequate endocrine adjuvant therapy? Results from two International Breast Cancer Study Group randomized trials of chemoendocrine adjuvant therapy for early breast cancer
- 1 February 2010
- journal article
- research article
- Published by Elsevier BV in Annals Of Oncology
- Vol. 21 (2), 245-254
- https://doi.org/10.1093/annonc/mdp317
Abstract
Peritumoral vascular invasion (PVI) may assist in assigning optimal adjuvant systemic therapy for women with early breast cancer. Patients participated in two International Breast Cancer Study Group randomized trials testing chemoendocrine adjuvant therapies in premenopausal (trial VIII) or postmenopausal (trial IX) node-negative breast cancer. PVI was assessed by institutional pathologists and/or central review on hematoxylin-eosin-stained slides in 99% of patients (analysis cohort 2754 patients, median follow-up >9 years). PVI, present in 23% of the tumors, was associated with higher grade tumors and larger tumor size (trial IX only). Presence of PVI increased locoregional and distant recurrence and was significantly associated with poorer disease-free survival. The adverse prognostic impact of PVI in trial VIII was limited to premenopausal patients with endocrine-responsive tumors randomized to therapies not containing goserelin, and conversely the beneficial effect of goserelin was limited to patients whose tumors showed PVI. In trial IX, all patients received tamoxifen: the adverse prognostic impact of PVI was limited to patients with receptor-negative tumors regardless of chemotherapy. Adequate endocrine adjuvant therapy appears to abrogate the adverse impact of PVI in node-negative disease, while PVI may identify patients who will benefit particularly from adjuvant therapy.Keywords
Funding Information
- International Breast Cancer Study Group
- Swiss Group for Clinical Cancer Research
- Frontier Science and Technology Research Foundation
- Cancer Council Australia
- Australian New Zealand Breast Cancer Trials Group
- National Health Medical Research Council (920876, 950328, 980379, 100925)
- National Cancer Institute (CA-75362)
- Swedish Cancer Society; Foundation for Clinical Cancer Research of Eastern Switzerland
- Cancer Association of South Africa
This publication has 32 references indexed in Scilit:
- Chemoendocrine Compared With Endocrine Adjuvant Therapies for Node-Negative Breast Cancer: Predictive Value of Centrally Reviewed Expression of Estrogen and Progesterone Receptors—International Breast Cancer Study GroupJournal of Clinical Oncology, 2008
- Prognostic role of the extent of peritumoral vascular invasion in operable breast cancerAnnals Of Oncology, 2007
- Distinguishing blood and lymph vessel invasion in breast cancer: a prospective immunohistochemical studyBritish Journal of Cancer, 2006
- Prognostic value of lymphovascular invasion in women with lymph node negative invasive breast carcinomaEuropean Journal Of Cancer, 2006
- Predicting the status of axillary sentinel lymph nodes in 4351 patients with invasive breast carcinoma treated in a single institutionCancer, 2005
- Prognostic Significance of Vascular and Perineural Invasion in Urothelial Bladder Cancer Treated With Radical CystectomyJournal of Urology, 2003
- Tumorgefäßinvasion beim Mammakarzinom: Hämatoxylin-Eosin- versus immunhistochemische Färbung gegen Faktor-VIII-Antigen*Deutsche Medizinische Wochenschrift (1946), 1994
- Herbal remedies—an alternativeThe Lancet, 1990
- A Class of $K$-Sample Tests for Comparing the Cumulative Incidence of a Competing RiskThe Annals of Statistics, 1988
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958