| Author/Editor | Colleoni, Marco; Bonetti, Marco; Coates, Alan S; Castiglione-Gertsch, Monica; Gelber, Richard D; Price, Karen; Rudenstam, Carl-Magnus; Lindtner, Jurij; Collins, John; Thuerlimann, Beat | |
| Title | Early start of adjuvant chemotherapy may improve treatment outcome for premenopausal breast cancer patients with tumors not expressing estrogen receptors | |
| Type | članek | |
| Source | J Clin Oncol | |
| Vol. and No. | Letnik 18, št. 3 | |
| Publication year | 2000 | |
| Volume | str. 584-90 | |
| Language | eng | |
| Abstract | Purpose: The proper time to commence adjuvant chemotherapy after primary surgery for breast cancer is unknown. An analysis of the International (Ludwig) Breast Cancer Study Group (IBCSG) Trial V at a median follow-up of 11 years suggested that early initiation of adjuvant chemotherapy might improve outcome for premenopausal, node-positive patients whose tumors did not express any estrogen receptor (ER). Patients and methods: We investigated the relationship between early initiation of adjuvant chemotherapy, ER status, and prognosis in 1,788 premenopausal, node-positive patients treated on IBCSG trials I, II, and VI. The disease-free survival for 599 patients (84 with ER-absent tumors) who commenced adjuvant chemotherapy within 20 days (early initiation) was compared with the disease-free survival for 1,189 patients (142 with ER-absent tumors) who started chemotherapy 21 to 86 days after surgery (conventional initiation). The median follow-up was 7.7 years. Results: Among patients with ER-absent tumors, the 10-year disease-free survival was 60% for the early initiation group compared with 34% for the conventional initiation group (226 patients; hazard ratio (HR), 0. 49; 95% confidence interval (CI), 0.33 to 0.72; P =.0003). This difference remained statistically significant in a Cox multiple regression analysis controlling for study group, number of positive nodes, tumor size, age, vessel invasion, and institution (HR, 0.60; 95% CI, 0.39 to 0.92; P =.019). Conversely, early initiation of chemotherapy did not significantly improve disease-free survival for patients with tumors expressing ER (1,562 patients; multiple regression HR, 0.93; 95% CI, 0.79 to 1.10; P =.40). Conclusion: In premenopausal patients with ER-absent tumors, early initiation of systemic chemotherapy after primary surgery might improve outcome. (Abstract truncated at 2000 characters). | |
| Descriptors | BREAST NEOPLASMS CHEMOTHERAPY, ADJUVANT PREMENOPAUSE RECEPTORS, ESTROGEN PROGNOSIS |