Survival from operable breast cancer: prognostic factors in Yogyakarta, Indonesia.
OBJECTIVE
The aim of this study was to determine most significant prognostic factor for overall survival of invasive duct operable breast cancer from clinical stage, pathological stage, epidemiological, anatomic and cellular and molecular genetic factors.


METHODS
Research design was prospective cohort. Duct invasive operable breast cancer patients who were diagnosed and treated with standard protocol since 1993, followed prospectively until November 2003 by clinical stage, pathological stage, age, tumor size, lymph node status, histological grade, mitotic index, ER,PR, c-erbB2, p53 and MIB-1, until revealed outcome (death). Prognostic factor was analyzed univariately for overall survival with Kaplan Meier method. Difference between two survival group was analyzed with log- rank test. Independent prognostic factor was analyzed multivariately using proportional hazard (Cox) regression.


RESULTS
With univariate analysis, significant prognostic factors for overall survival were clinical stage (p<0.001), pathological stage (p<0.001), tumor size (p<0.001), lymph node status (p<0.001) and adjuvant chemotherapy (p<0.005). Multivariately, most significant prognostic factors for survival were lymph node status (p=0.001; Exp beta=7.775; 95% CI: 2.276-26.56) and clinical stage (p=0.029; Exp beta=2.142; 95% CI: 1.081-4.244).


CONCLUSIONS
Independent prognostic factors for survival are lymph node status and clinical stage.
Aryandono
Teguh
T
Department of Surgery, Faculty of Medicine, Gadjah Mada University, Jl. Kesehatan No. 1, Yogyakarta 55284, Indonesia. gagoek@idola.net.id
Harijadi
Soeripto
D001943:Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000378:metabolism / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D019394:Ki-67 Antigen / Q000378:metabolism*; D008207:Lymphatic Metastasis / Q000473:pathology; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D016159:Tumor Suppressor Protein p53