Acute phase proteins in patients with large and locally advanced breast cancer treated with neo-adjuvant chemotherapy: response and survival.
Seventy-seven patients with locally advanced breast cancer were treated with multimodality therapy comprising of six pulses of neo-adjuvant chemotherapy (doxorubicin, cyclophosphamide, vincristine and prednisolone) at 21-day intervals, followed by surgery (breast conservation or mastectomy) with appropriate axillary surgery, radiotherapy and adjuvant tamoxifen. The serum concentrations of acute phase proteins, C-reactive protein (CRP), á-1-anti-trypsin, albumin and transferrin were measured in serum taken prior to commencement of treatment. Patients were followed up for a median of 31 months and their clinical and histological responses and overall survival recorded. Univariate analyses revealed that tumour stage (p=0.01), clinical lymph node status (p=0. 02) and pre-treatment levels of serum albumin (p=0.002) and á-1-anti-trypsin (p=0.06) predicted overall survival. Using the Cox proportional hazards model reduced pre-treatment levels of serum albumin (p<0.00001), progressive lymph node involvement with tumour (p<0.005), and advancing tumour stage (p<0.01) were independent prognostic indicators for a poorer survival in patients with locally advanced breast cancer receiving neo-adjuvant chemotherapy.
Heys
S D
SD
Surgical Nutrition and Metabolism Unit, Department of Surgery, Medical School Buildings, Foresterhill, Aberdeen AB9 2ZD, UK.
Ogston
K N
KN
Simpson
W G
WG
Walker
L G
LG
Hutcheon
A W
AW
Sarkar
T K
TK
Eremin
O
O
D000209:Acute-Phase Proteins / Q000187:drug effects / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery; D002097:C-Reactive Protein / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D012709:Serum Albumin / Q000378:metabolism; D016019:Survival Analysis; D014168:Transferrin / Q000378:metabolism; D014750:Vincristine / Q000008:administration & dosage; D000515:alpha 1-Antitrypsin / Q000378:metabolism
D000209:Acute-Phase Proteins; D012709:Serum Albumin; D014168:Transferrin; D000515:alpha 1-Antitrypsin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002097:C-Reactive Protein; D011239:Prednisolone