Prognostic significance of biologic markers in node-negative breast cancer patients: a prospective study
- 1 October 2000
- journal article
- Published by Springer Science and Business Media LLC in Breast Cancer Research and Treatment
- Vol. 63 (3), 181-192
- https://doi.org/10.1023/a:1006464426977
Abstract
It is generally thought that future advances in the treatment and cure of breast cancer patients will be made possible through a deeper understanding of tumor biology and an improved capability to define the prognosis of each single patient. This will lead to the formulation of new, more selective, and patient-tailored therapies. It is therefore important, when studying potential prognostic factors, to follow methodologic requirements and guidelines which involve the carrying out of prospective studies as confirmatory steps. Repeatedly or recently investigated prognostic markers (tumor size, menopausal status, ER, PgR, 3H thymidine labeling index, c-erbB-2 and p27 expression) were evaluated on a series of 286 prospectively recruited node negative breast cancer patients who underwent loco-regional treatment alone and were closely followed. The individual and relative prognostic contribution of each variable with respect to other factors, as well as their ability to identify node negative patients at risk, were assessed by univariate and multivariate analysis. At a five-year follow-up, only tumor size (p = 0.021) and TLI (p = 0.016) individually proved to be significant prognostic indicators of relapse-free survival. Conversely, p27 expression was not related to RFS and c-erbB-2 expression appeared to have only a short-term effect on patient prognosis. TLI and tumor size, tested in multivariate analysis along with ER and menopausal status, maintained their independent prognostic relevance. The study, performed on a large series of node-negative patients given loco-regional treatment alone, for the first time prospectively recruited, showed the prognostic relevance of TLI and its independence from other clinico-pathologic and biologic factors over a five-year period.Keywords
This publication has 52 references indexed in Scilit:
- Coexpression of HER-2/neu and p53 is associated with a shorter disease-free survival in node-positive breast cancer patientsZeitschrift für Krebsforschung und Klinische Onkologie, 1994
- The p53 tumour suppressor geneNature, 1991
- Relationship between c-erbB-2 immunoreactivity and thymidine labelling index in breast carcinomain situBreast Cancer Research and Treatment, 1991
- What Is the Evidence That Tumors Are Angiogenesis Dependent?JNCI Journal of the National Cancer Institute, 1990
- Prolonged Disease-Free Survival after One Course of Perioperative Adjuvant Chemotherapy for Node-Negative Breast CancerNew England Journal of Medicine, 1989
- Efficacy of Adjuvant Chemotherapy in High-Risk Node-Negative Breast CancerNew England Journal of Medicine, 1989
- Proliferative index of breast carcinoma by thymidine labeling: Prognostic power independent of stage, estrogen and progesterone receptorsBreast Cancer Research and Treatment, 1988
- The DNA labelling index: A prognostic factor in node-negative breast cancerBreast Cancer Research and Treatment, 1987
- Prognostic implication of labeling index versus estrogen receptors and tumor size in node-negative breast cancerBreast Cancer Research and Treatment, 1986
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958