Extracapsular tumor spread and the risk of local, axillary and supraclavicular recurrence in node-positive, premenopausal patients with breast cancer.
Details
Serval ID
serval:BIB_4D4A32C80545
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Extracapsular tumor spread and the risk of local, axillary and supraclavicular recurrence in node-positive, premenopausal patients with breast cancer.
Journal
Annals of Oncology
Working group(s)
International Breast Cancer Study Group
Contributor(s)
Stahel R., de Stoppani M., Green M., Hiltbrunner A., Hossfeld DK., Karlsson P., Kössler I., Láng I., Castiglione M., Veronesi A., Egli G., Rabaglio M., Maibach R., Studer R., Ruepp B., Bärtschi D., Price B., Regan M., Sun Z., Gelber S., Giobbie-Hurder A., Dasgupta M., Nickerson L., Blacher L., Hinkle R., Celano J., Scolese T., Mallon E., Crivellari D., Monfardini S., Galligioni E., Magri MD., Buonadonna A., Massarut S., Rossi C., Candiani E., Carbone A., Volpe R., Roncadin M., Coran F., Morassut S., Simoncini E., Marini G., Marpicati P., Lucini L., Grigolato P., Morassi L., Farfaglia R., Bianchi AM., Murray E., Dent DM., Gudgeon A., Werner ID., Hacking A., Tiltman A., McEvoy E., Toop J., Rudenstam CM., Holmberg SB., Karlsson P., Wallgren A., Ottosson-Lönn S., Hultborn R., Colldahl-Jädeström G., Cahlin E., Mattsson J., Ruusvik O., Niklasson LG., Dahlin S., Karlsson G., Lindberg B., Sundbäck A., Bergegârdh S., Groot O., Dahlbäck LO., Salander H., Andersson C., Heideman M., Nissborg A., Wallin A., Claes G., Ramhult T., Svensson JH., Liedberg P., Nilsson A., Oestberg G., Persson S., Matusik J., Lindtner J., Erzen D., Cufer T., Majdic E., Stabuc B., Golouh R., Lamovec J., Jancar J., Vrhovec I., Kramberger M., Novak J., Naglas M., Sencar M., Cervek J., Sebek S., Cerar O., Plesnicar A., Zakotnik B., Cortès-Funes H., Mendiola C., Gravalos C., Mendez M., Cruz Vigo F., Miranda P., Sierra A., Martinez-Tello F., Garzon A., Alonso S., Ferrero A., Vargas C., Forbes JF., Lindsay D., Simes RJ., Beller E., Stone C., Gebski V., Snyder R., Abdi E., Basser R., Bennett R., Briggs P., Brodie P., Burns WI., Chipman M., Chirgwin J., Drummond R., Ellims P., Finkelde D., Francis P., Funder J., Gale T., Green M., Gregory P., Griffiths J., Goss G., Harrison L., Hart S., Henderson M., Humenuik V., Jeal P., Kitchen P., Lindeman G., Mann B., McKendrick J., McLennan R., Millar R., Murphy C., Neil S., Olver I., Pitcher M., Read A., Reading D., Reed R., Richardson G., Rodger A., Russell I., Schwarz M., Sisely L., Stanley R., Steele M., Stewart J., Underhill C., Zalcberg J., Zimet A., Birrell S., Eaton M., Hoffmann C., Koczwara B., Karapetis C., Malden T., McLeay W., Seshadri R., Forbes JF., Stewart J., Jackson D., Gourlay R., Bishop J., Cox S., Ackland S., Bonaventura A., Hamilton C., Denham J., O'Brien P., Back M., Brae S., Price A., Muragasu R., Foster H., Clarke D., Sillar R., MacDonald I., Hitchins R., Olver IN., Keefe D., Brown M., Gill PG., Taylor A., Robertson A., Gill PG., Carter ML., Malycha P., Yeoh E., Ward G., Leong AS., Lommax-Smith J., Horsfall D., D'Angelo R., Abdi E., Cleary J., Parnis F., Bayliss E., Byrne M., van Hazel G., Dewar J., Buck M., Ingram D., Sterrett G., Reynolds PM., Sheiner HJ., Shilkin KB., Hahnel R., Levitt S., Kermode D., Hahnel H., Hastrich D., Joseph D., Cameron F., Tattersall MH., Coates A., Niesche F., West R., Renwick S., Donovan J., Duval D., Simes RJ., Ng A., Glenn D., North RA., Beith J., O'Connor RG., Rice M., Stevens G., Grassby J., Pendlebury S., McLeod C., Boyer M., Sullivan A., Hobbs J., Fox R., Hedley D., Raghavan D., Green D., Foo T., Nash TJ., Grygiel J., Lind D., Lewis C., Friedlander M., Kay RG., Holdaway IM., Harvey VJ., Benjamin CS., Thompson P., Bierre A., Miller M., Hochstein B., Lethaby A., Webber J., Jagusch MF., Neave L., Mason BM., Evans B., Carter JF., Gillman JC., Mack D., Benson-Cooper D., Probert J., Wood H., Anderson J., Yee L., Hitchcock GC., Lethaby A., Webber J., Porter D., Kennedy I., Round G., Long J., Fey MF., Aebi S., Dreher E., Buser K., Ludin J., Beck G., Lüthi JM., Altermatt HJ., Nandedkar M., Senn HJ., Oehlschlegel Ch., Ries G., Töpfer M., Lorenz U., Ehrsam A., Späti B., Vogel E., Cavalli F., Pagani O., Neuenschwander H., Sessa C., Ghielmini M., Zucca E., Bernier J., Pedrinis ES., Rusca T., Passega E., Bronz L., Rey P., Galfetti M., Sanzeni W., Gyr T., Leidi L., Pastorelli G., Varini M., Longhi S., Cafaro-Greco C., Graffeo R., Goldhirsch A., Herrmann R., Rochlitz CF., Harder JF., Köchli O., Eppenberger U., Torhorst J., Piguet D., Siegenthaler P., Barrelet V., Baumann RP., Pestalozzi B., Sauter C., Haller U., Metzger U., Huguenin P., Caduff R., Perey L., Zaman K., Leyvraz S., De Grandi P., Jeanneret-Sozzi W., Mirimanoff R., Delaloye JF., Nobahar M., Alberto P., Bonnefoi H., Schäfer P., Krauer F., Forni M., Aapro M., Egeli R., Megevand R., Jacot-des-Combes E., Schindler A., Borisch B., Diebold S., Egli F., Willi A., Steiner R., Allemann J., Rüedi T., Leutenegger A., Dalla Torre T.
ISSN
1569-8041 (Electronic)
ISSN-L
0923-7534
Publication state
Published
Issued date
2008
Volume
19
Number
8
Pages
1393-1401
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
BACKGROUND: Extracapsular tumor spread (ECS) has been identified as a possible risk factor for breast cancer recurrence, but controversy exists regarding its role in decision making for regional radiotherapy. This study evaluates ECS as a predictor of local, axillary, and supraclavicular recurrence.
PATIENTS AND METHODS: International Breast Cancer Study Group Trial VI accrued 1475 eligible pre- and perimenopausal women with node-positive breast cancer who were randomly assigned to receive three to nine courses of classical combination chemotherapy with cyclophosphamide, methotrexate, and fluorouracil. ECS status was determined retrospectively in 933 patients based on review of pathology reports. Cumulative incidence and hazard ratios (HRs) were estimated using methods for competing risks analysis. Adjustment factors included treatment group and baseline patient and tumor characteristics. The median follow-up was 14 years.
RESULTS: In univariable analysis, ECS was significantly associated with supraclavicular recurrence (HR = 1.96; 95% confidence interval 1.23-3.13; P = 0.005). HRs for local and axillary recurrence were 1.38 (P = 0.06) and 1.81 (P = 0.11), respectively. Following adjustment for number of lymph node metastases and other baseline prognostic factors, ECS was not significantly associated with any of the three recurrence types studied.
CONCLUSIONS: Our results indicate that the decision for additional regional radiotherapy should not be based solely on the presence of ECS.
PATIENTS AND METHODS: International Breast Cancer Study Group Trial VI accrued 1475 eligible pre- and perimenopausal women with node-positive breast cancer who were randomly assigned to receive three to nine courses of classical combination chemotherapy with cyclophosphamide, methotrexate, and fluorouracil. ECS status was determined retrospectively in 933 patients based on review of pathology reports. Cumulative incidence and hazard ratios (HRs) were estimated using methods for competing risks analysis. Adjustment factors included treatment group and baseline patient and tumor characteristics. The median follow-up was 14 years.
RESULTS: In univariable analysis, ECS was significantly associated with supraclavicular recurrence (HR = 1.96; 95% confidence interval 1.23-3.13; P = 0.005). HRs for local and axillary recurrence were 1.38 (P = 0.06) and 1.81 (P = 0.11), respectively. Following adjustment for number of lymph node metastases and other baseline prognostic factors, ECS was not significantly associated with any of the three recurrence types studied.
CONCLUSIONS: Our results indicate that the decision for additional regional radiotherapy should not be based solely on the presence of ECS.
Keywords
Adult, Antineoplastic Combined Chemotherapy Protocols/administration & dosage, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Breast Neoplasms/drug therapy, Breast Neoplasms/pathology, Combined Modality Therapy, Cyclophosphamide/administration & dosage, Female, Fluorouracil/administration & dosage, Follow-Up Studies, Humans, Lymphatic Metastasis, Methotrexate/administration & dosage, Neoplasm Recurrence, Local/pathology, Neoplasm Staging, Premenopause, Retrospective Studies, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
05/03/2009 16:23
Last modification date
20/08/2019 15:02
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