For patients treated with neoadjuvant chemo, age, tumor and clinical characteristics predict risk
THURSDAY, Oct. 4 (HealthDay News) -- In breast cancer patients treated with neoadjuvant chemotherapy (NC), independent predictors of locoregional recurrence (LRR) can be used to identify LRR risk, according to research published online Oct. 1 in the Journal of Clinical Oncology.
In an effort to examine predictors of LRR after NC, Eleftherios P. Mamounas, M.D., of the National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers in Pittsburg, and colleagues conducted a study of 3,088 patients who had participated in two NSABP neoadjuvant trials. NC was doxorubicin/cyclophosphamide (AC) alone or AC followed by docetaxel. Lumpectomy patients were treated with radiotherapy alone, while mastectomy patients received no radiotherapy.
After 10 years of follow-up, the researchers identified 335 LRR events. The 10-year cumulative incidence of LRR was 10.3 percent for lumpectomy and breast radiotherapy patients and 12.3 percent for mastectomy patients. In lumpectomy patients, independent predictors of LRR included age, clinical nodal status (before NC), and pathologic nodal status/breast tumor response. In mastectomy patients, independent predictors of LRR included clinical tumor size and nodal status (before NC) and pathologic nodal status/breast tumor response. These predictors could be used to identify groups at low, intermediate, and high risk of LRR, and nomograms incorporating these predictors were developed.
"In patients treated with NC, age, clinical tumor characteristics before NC, and pathologic nodal status/breast tumor response after NC can be used to predict risk for LRR and to optimize the use of adjuvant radiotherapy," Mamounas and colleagues conclude.
One author disclosed financial ties to Sanofi-Aventis. One of the editorial authors disclosed financial ties to Varian Medical Systems.
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