Prognostic effect of preoperative serum estradiol level in postmenopausal breast cancer

BMC Cancer

Dong-Young Noh¹  Taeryung Kim³  Min Kyoon Kim¹  Jun Woo Lee¹  Jisun Kim¹  Soo Kyung Ahn¹  Hyeong-Gon Moon¹  Wonshik Han¹  Ju-Yeon Kim² 

[1]Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Seoul 110-744, Korea

[2]Department of Surgery, Gyeongsang National University Hospital, 90 Chilamdong, Jinju, Korea

[3]Department of Surgery, Gachon University Gil Hospital, 1198, Guwol-Dong, Incheon 405-760, Korea

关键词: Survival;    Metastasis;    Postmenopause;    Estradiol;   

Others  :  1079491
DOI  :  10.1186/1471-2407-13-503

 received in 2013-07-19, accepted in 2013-10-23,  发布年份 2013

【 摘 要 】

Background

The prognostic role of serum estrogen level in breast cancer patients is unclear. We investigated the prognostic importance of preoperative serum estradiol (E2) level in postmenopausal women according to their estrogen receptor (ER) status.

Methods

The medical records of 313 postmenopausal breast cancer patients who underwent surgery between 2006 and 2008 at a single institution were retrospectively evaluated. Patients who received neoadjuvant chemotherapy, synchronous bilateral breast cancer, or those with metastasis at diagnosis were excluded. Serum E2 and follicular stimulating hormone (FSH) levels were measured by radioimmunoassay and immunoradiometric assay, respectively, within 3 months prior to surgery. After a median follow-up of 52.0 months (11–77 months), 21 women were found to have metastatic disease.

Results

The overall, median E2 level was 13.0 pg/ml, and was slightly higher in ER-positive than ER-negative (p=0.69). The mean serum E2 level was significantly higher in patients with metastasis (17.41±8.34 pg/ml) than in those without metastasis (13.54±7.58 pg/ml) (p=0.02). Kaplan-Meier analysis using a cut-off of 13 pg/ml showed that, ER negative (p=0.02) but not ER positive (p>0.05) patients with higher E2 level showed significantly poorer metastasis-free survival. Multivariate analysis showed that, the high E2 level of ER negative tumors was an independent negative prognostic factor for metastasis- free survival (HR, 3.32; 95% CI, 1.05 to 10.51; p=0.04).

Conclusions

Higher preoperative serum E2 level had a negative prognostic effect in postmenopausal women with breast cancer, especially in the ER-negative subgroup.

【 授权许可】

   
2013 Kim et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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