Immunohistochemical subtypes predict the clinical outcome in high-risk node-negative breast cancer patients treated with adjuvant FEC regimen: results of a single-center retrospective study

BMC Cancer

Research Article

L. Laborde¹  J. Thomassin-Piana²  E. Charafe-Jauffret³  J M Boher⁴  S. Rahal⁵  C. Tarpin⁵  J M Extra⁶  F. Bertucci⁷  R. Sabatier⁷  A. Gonçalves⁷  P. Viens⁷  M. Resbeut⁸  A. Tallet⁸  E. Lambaudie⁹  G. Houvenaeghel^1,10 

[1] Data Management and Analysis Center, Institut Paoli-Calmettes, Marseille, France;Department of Biopathology, Institut Paoli-Calmettes, Marseille, France;Centre de Recherche en Cancérologie de Marseille, U1068 INSERM, U7258 CNRS, Marseille, France;Department of Biopathology, Institut Paoli-Calmettes, Marseille, France;Centre de Recherche en Cancérologie de Marseille, U1068 INSERM, U7258 CNRS, Marseille, France;Aix-Marseille University, Marseille, France;Department of Biostatistics, Institut Paoli-Calmettes, Marseille, France;Centre de Recherche en Cancérologie de Marseille, U1068 INSERM, U7258 CNRS, Marseille, France;Department of Medical Oncology, Institut Paoli-Calmettes, 232 Bd. Sainte-Marguerite, 13009, Marseille, France;Department of Medical Oncology, Institut Paoli-Calmettes, 232 Bd. Sainte-Marguerite, 13009, Marseille, France;Centre de Recherche en Cancérologie de Marseille, U1068 INSERM, U7258 CNRS, Marseille, France;Department of Medical Oncology, Institut Paoli-Calmettes, 232 Bd. Sainte-Marguerite, 13009, Marseille, France;Centre de Recherche en Cancérologie de Marseille, U1068 INSERM, U7258 CNRS, Marseille, France;Aix-Marseille University, Marseille, France;Department of Radiation Oncology, Institut Paoli-Calmettes, Marseille, France;Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France;Centre de Recherche en Cancérologie de Marseille, U1068 INSERM, U7258 CNRS, Marseille, France;Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France;Centre de Recherche en Cancérologie de Marseille, U1068 INSERM, U7258 CNRS, Marseille, France;Aix-Marseille University, Marseille, France;

关键词: Breast cancer;    Adjuvant chemotherapy;    Anthracycline;    Taxane;    Peritumoral vascular invasion;    Molecular subtypes;    Prognostic factors;    Node-negative;   

DOI  :  10.1186/s12885-015-1746-3

 received in 2015-02-12, accepted in 2015-10-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAnthracycline-based adjuvant chemotherapy improves survival in patients with high-risk node-negative breast cancer (BC). In this setting, prognostic factors predicting for treatment failure might help selecting among the different available cytotoxic combinations.MethodsBetween 1998 and 2008, 757 consecutive patients with node-negative BC treated in our institution with adjuvant FEC (5FU, epirubicin, cyclophosphamide) chemotherapy were identified. Data collection included demographic, clinico-pathological characteristics and treatment information. Molecular subtypes were derived from estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status and Scarff-Bloom-Richardson (SBR) grade. Disease-free survival (DFS), distant disease-free survival (DDFS) and overall survival (OS) were estimated using the Kaplan-Meier Method, and prognostic factors were examined by multivariate Cox analysis.ResultsAfter a median follow-up of 70 months, the 5-year DFS, DDFS and OS were 90.6 % (95 % confidence interval (CI): 88.2–93.1), 92.8 % (95 % CI: 90.7–95) and 95.1 % (95 % CI, 93.3–96.9), respectively. In the multivariate analysis including classical clinico-pathological parameters, only grade 3 maintained a significant and independent adverse prognostic impact. In an alternative multivariate model where ER, PR and grade were replaced by molecular subtypes, only luminal B/HER2-negative and triple-negative subtypes were associated with reduced DFS and DDFS.ConclusionsNode-negative BC patients receiving adjuvant FEC regimen have a favorable outcome. Luminal B/HER2-negative and triple-negative subtypes identify patients with a higher risk of treatment failure, which might warrant more aggressive systemic treatment.

【 授权许可】

CC BY   
© Rahal et al. 2015