Treatment outcome in patients with stage III breast cancer treated with neoadjuvant chemotherapy.
Despite the good responses of patients (pts) with stage III breast cancer to neoadjuvant chemotherapy (NAC), most eventually relapse and have a poor prognosis. We investigated the prognostic indicators in pts with stage III breast cancer treated with NAC, using epirubicin and/or docetaxel. A total of 22 women with stage III breast cancer underwent NAC between January 2005 and May 2011. The regimens of NAC comprised ED (epirubicin 60 mg/m2and docetaxel 60 mg/m2) in 10 cases, FEC (fluorouracil 500 mg/m2, epirubicin 75-100 mg/m2and cyclophosphamide 500 mg/m2) in 10 cases and EC (epirubicin 60 mg/m2and cyclophosphamide 600 mg/m2) in two cases. Following four cycles of each regimen, a further four cycles of D (docetaxel 70 mg/m2) were undertaken in nine cases. Subsequent to the completion of NAC and surgery, we assessed the clinicopathological results and performed prognostic analyses. Statistical analyses concerning disease-free survival (DFS) or overall survival (OS) were conducted by a Cox proportional hazard model. The median survival time was 66 months and there were 12 distant metastases and two local recurrences. Multivariate analyses showed the number of metastatic axillary lymph nodes (ALNs) [hazard ratio (HR), 1.079; P=0.023] was correlated with DFS, while the Ki-67 labeling index (HR, 1.109; P=0.042) and the number of meta-static ALNs (HR, 1.087; P=0.023) were correlated with OS. In conclusion, even if pts with stage III breast cancer show good responses to NAC using epirubicin and/or docetaxel, the majority eventually relapse and have a poor prognosis. The Ki-67 labeling index and the number of involved ALNs are suggested as prognostic indicators in stage III breast cancer.
Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan.
Ryuji
R
Takahashi
Uhi
U
Toh
Nobutaka
N
Iwakuma
Mai
M
Mishima
Teruhiko
T
Fujii
Miki
M
Takenaka
Keiko
K
Koura
Naoko
N
Seki
Akihiko
A
Kawahara
Mashayoshi
M
Kage
Etsuyo
E
Ogo
Kazuo
K
Shirouzu
neoadjuvant chemotherapy; prognostic indicator; stage III breast cancer; treatment outcome