“Long-Term Outcomes in Stage IIIB Breast Cancer Patients Who Achieved Less Than a Pathological Complete Response (<pCR) After Primary Chemotherapy”

Sergio Palmeri, Monica Murgia, Valeria Pusceddu, Maria Cristina Deidda, Francesco Atzori, Michela Barca, Barbara Frau, Luigi Minerba, Maria Teresa Ionta, Bruno Massidda, Sergio Palmeri

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3 Citazioni (Scopus)

Abstract

Purpose. Pathological complete response (pCR) to primary chemotherapy is the main determinant for improved disease-free survival (DFS) and overall survival (OS). The primary endpoints of our study were the long-term DFS and OS rates in homogeneously treated stage IIIB breast cancer patients who failed to achieve a pCR (<pCR), in relation to residual tumor burden. The secondary endpoint was the prognostic relevance of hormone receptor (HR) and human epidermal growth factor receptor (HER)-2 status. Methods. We analyzed 58 of 74 consecutive stage IIIB patients treated between 1996 and 2001 who achieved <pCR following a primary cisplatin, epirubicin, and vinorelbine regimen for up to six cycles. At the time of patient accrual, trastuzumab was not available. After definitive surgery, pathological residual disease remained in 40 (69%) patients in both the breast and axilla, in 14 (24%) patients in only the breast, and in four (7%) patients in only the axilla. Results. Fifty-eight (78%) of 74 patients achieved <pCR and 16 (22%) had pCR both in the breast and axilla. After a median follow-up of 99 months (range, 72-134 months), in patients with <pCR the estimated 10-year DFS and OS rates were 37.6% and 50.3%, respectively, significantly worse than in the pCR group (p = .003 and p = .008, respectively). Patients with four or more axillary nodes involved had a significantly worse 10-year DFS rate (28.9% versus 62.7%; p.036). Patients with HR- tumors had significantly lower 10-year DFS (17.3% versus 46.4%; p = .018) and OS (17.3% versus 70.2%; p = .002) rates. Overall, the triple-negative (TN) group showed only a marginally significantly worse OS rate (p = .048). HER-2 status alone, in the absence of trastuzumab, did not appear to significantly affect outcomes. Conclusions. Our data suggest that, in stage IIIB patients who achieve <pCR, the number of residual nodes and HR - status are strong predictors of poor outcomes. After a long follow-up time, HER-2 expression does not appear to significantly affect DFS and OS. TN patients showed a trend toward early recurrence and death.
Lingua originaleEnglish
pagine (da-a)1051-1060
Numero di pagine10
RivistaTHE ONCOLOGIST
Volume14
Stato di pubblicazionePublished - 2009

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Breast Neoplasms
Drug Therapy
Disease-Free Survival
Axilla
Survival Rate
Breast
Hormones
Survival
Epirubicin
Residual Neoplasm
Tumor Burden
Cisplatin
Recurrence
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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“Long-Term Outcomes in Stage IIIB Breast Cancer Patients Who Achieved Less Than a Pathological Complete Response (<pCR) After Primary Chemotherapy”. / Palmeri, Sergio; Murgia, Monica; Pusceddu, Valeria; Deidda, Maria Cristina; Atzori, Francesco; Barca, Michela; Frau, Barbara; Minerba, Luigi; Ionta, Maria Teresa; Massidda, Bruno; Palmeri, Sergio.

In: THE ONCOLOGIST, Vol. 14, 2009, pag. 1051-1060.

Risultato della ricerca: Article

Palmeri, S, Murgia, M, Pusceddu, V, Deidda, MC, Atzori, F, Barca, M, Frau, B, Minerba, L, Ionta, MT, Massidda, B & Palmeri, S 2009, '“Long-Term Outcomes in Stage IIIB Breast Cancer Patients Who Achieved Less Than a Pathological Complete Response (<pCR) After Primary Chemotherapy”', THE ONCOLOGIST, vol. 14, pagg. 1051-1060.
Palmeri, Sergio ; Murgia, Monica ; Pusceddu, Valeria ; Deidda, Maria Cristina ; Atzori, Francesco ; Barca, Michela ; Frau, Barbara ; Minerba, Luigi ; Ionta, Maria Teresa ; Massidda, Bruno ; Palmeri, Sergio. / “Long-Term Outcomes in Stage IIIB Breast Cancer Patients Who Achieved Less Than a Pathological Complete Response (<pCR) After Primary Chemotherapy”. In: THE ONCOLOGIST. 2009 ; Vol. 14. pagg. 1051-1060.
@article{c37e16a307ee4ad284cce21e8cb5a10e,
title = "“Long-Term Outcomes in Stage IIIB Breast Cancer Patients Who Achieved Less Than a Pathological Complete Response (<pCR) After Primary Chemotherapy”",
abstract = "Purpose. Pathological complete response (pCR) to primary chemotherapy is the main determinant for improved disease-free survival (DFS) and overall survival (OS). The primary endpoints of our study were the long-term DFS and OS rates in homogeneously treated stage IIIB breast cancer patients who failed to achieve a pCR (<pCR), in relation to residual tumor burden. The secondary endpoint was the prognostic relevance of hormone receptor (HR) and human epidermal growth factor receptor (HER)-2 status. Methods. We analyzed 58 of 74 consecutive stage IIIB patients treated between 1996 and 2001 who achieved <pCR following a primary cisplatin, epirubicin, and vinorelbine regimen for up to six cycles. At the time of patient accrual, trastuzumab was not available. After definitive surgery, pathological residual disease remained in 40 (69{\%}) patients in both the breast and axilla, in 14 (24{\%}) patients in only the breast, and in four (7{\%}) patients in only the axilla. Results. Fifty-eight (78{\%}) of 74 patients achieved <pCR and 16 (22{\%}) had pCR both in the breast and axilla. After a median follow-up of 99 months (range, 72-134 months), in patients with <pCR the estimated 10-year DFS and OS rates were 37.6{\%} and 50.3{\%}, respectively, significantly worse than in the pCR group (p = .003 and p = .008, respectively). Patients with four or more axillary nodes involved had a significantly worse 10-year DFS rate (28.9{\%} versus 62.7{\%}; p.036). Patients with HR- tumors had significantly lower 10-year DFS (17.3{\%} versus 46.4{\%}; p = .018) and OS (17.3{\%} versus 70.2{\%}; p = .002) rates. Overall, the triple-negative (TN) group showed only a marginally significantly worse OS rate (p = .048). HER-2 status alone, in the absence of trastuzumab, did not appear to significantly affect outcomes. Conclusions. Our data suggest that, in stage IIIB patients who achieve <pCR, the number of residual nodes and HR - status are strong predictors of poor outcomes. After a long follow-up time, HER-2 expression does not appear to significantly affect DFS and OS. TN patients showed a trend toward early recurrence and death.",
keywords = "Long-term outcomes, Neoadjuvant chemotherapy, Pathological response, Stage IIIB breast cancer",
author = "Sergio Palmeri and Monica Murgia and Valeria Pusceddu and Deidda, {Maria Cristina} and Francesco Atzori and Michela Barca and Barbara Frau and Luigi Minerba and Ionta, {Maria Teresa} and Bruno Massidda and Sergio Palmeri",
year = "2009",
language = "English",
volume = "14",
pages = "1051--1060",
journal = "Oncologist",
issn = "1083-7159",
publisher = "AlphaMed Press",

}

TY - JOUR

T1 - “Long-Term Outcomes in Stage IIIB Breast Cancer Patients Who Achieved Less Than a Pathological Complete Response (<pCR) After Primary Chemotherapy”

AU - Palmeri, Sergio

AU - Murgia, Monica

AU - Pusceddu, Valeria

AU - Deidda, Maria Cristina

AU - Atzori, Francesco

AU - Barca, Michela

AU - Frau, Barbara

AU - Minerba, Luigi

AU - Ionta, Maria Teresa

AU - Massidda, Bruno

AU - Palmeri, Sergio

PY - 2009

Y1 - 2009

N2 - Purpose. Pathological complete response (pCR) to primary chemotherapy is the main determinant for improved disease-free survival (DFS) and overall survival (OS). The primary endpoints of our study were the long-term DFS and OS rates in homogeneously treated stage IIIB breast cancer patients who failed to achieve a pCR (<pCR), in relation to residual tumor burden. The secondary endpoint was the prognostic relevance of hormone receptor (HR) and human epidermal growth factor receptor (HER)-2 status. Methods. We analyzed 58 of 74 consecutive stage IIIB patients treated between 1996 and 2001 who achieved <pCR following a primary cisplatin, epirubicin, and vinorelbine regimen for up to six cycles. At the time of patient accrual, trastuzumab was not available. After definitive surgery, pathological residual disease remained in 40 (69%) patients in both the breast and axilla, in 14 (24%) patients in only the breast, and in four (7%) patients in only the axilla. Results. Fifty-eight (78%) of 74 patients achieved <pCR and 16 (22%) had pCR both in the breast and axilla. After a median follow-up of 99 months (range, 72-134 months), in patients with <pCR the estimated 10-year DFS and OS rates were 37.6% and 50.3%, respectively, significantly worse than in the pCR group (p = .003 and p = .008, respectively). Patients with four or more axillary nodes involved had a significantly worse 10-year DFS rate (28.9% versus 62.7%; p.036). Patients with HR- tumors had significantly lower 10-year DFS (17.3% versus 46.4%; p = .018) and OS (17.3% versus 70.2%; p = .002) rates. Overall, the triple-negative (TN) group showed only a marginally significantly worse OS rate (p = .048). HER-2 status alone, in the absence of trastuzumab, did not appear to significantly affect outcomes. Conclusions. Our data suggest that, in stage IIIB patients who achieve <pCR, the number of residual nodes and HR - status are strong predictors of poor outcomes. After a long follow-up time, HER-2 expression does not appear to significantly affect DFS and OS. TN patients showed a trend toward early recurrence and death.

AB - Purpose. Pathological complete response (pCR) to primary chemotherapy is the main determinant for improved disease-free survival (DFS) and overall survival (OS). The primary endpoints of our study were the long-term DFS and OS rates in homogeneously treated stage IIIB breast cancer patients who failed to achieve a pCR (<pCR), in relation to residual tumor burden. The secondary endpoint was the prognostic relevance of hormone receptor (HR) and human epidermal growth factor receptor (HER)-2 status. Methods. We analyzed 58 of 74 consecutive stage IIIB patients treated between 1996 and 2001 who achieved <pCR following a primary cisplatin, epirubicin, and vinorelbine regimen for up to six cycles. At the time of patient accrual, trastuzumab was not available. After definitive surgery, pathological residual disease remained in 40 (69%) patients in both the breast and axilla, in 14 (24%) patients in only the breast, and in four (7%) patients in only the axilla. Results. Fifty-eight (78%) of 74 patients achieved <pCR and 16 (22%) had pCR both in the breast and axilla. After a median follow-up of 99 months (range, 72-134 months), in patients with <pCR the estimated 10-year DFS and OS rates were 37.6% and 50.3%, respectively, significantly worse than in the pCR group (p = .003 and p = .008, respectively). Patients with four or more axillary nodes involved had a significantly worse 10-year DFS rate (28.9% versus 62.7%; p.036). Patients with HR- tumors had significantly lower 10-year DFS (17.3% versus 46.4%; p = .018) and OS (17.3% versus 70.2%; p = .002) rates. Overall, the triple-negative (TN) group showed only a marginally significantly worse OS rate (p = .048). HER-2 status alone, in the absence of trastuzumab, did not appear to significantly affect outcomes. Conclusions. Our data suggest that, in stage IIIB patients who achieve <pCR, the number of residual nodes and HR - status are strong predictors of poor outcomes. After a long follow-up time, HER-2 expression does not appear to significantly affect DFS and OS. TN patients showed a trend toward early recurrence and death.

KW - Long-term outcomes

KW - Neoadjuvant chemotherapy

KW - Pathological response

KW - Stage IIIB breast cancer

UR - http://hdl.handle.net/10447/45310

M3 - Article

VL - 14

SP - 1051

EP - 1060

JO - Oncologist

JF - Oncologist

SN - 1083-7159

ER -