A prognostic model based on nodal status and Ki-67 predicts the risk of recurrence and death in breast cancer patients with residual disease after preoperative chemotherapy

Valentina Guarneri, F. Piacentini, G. Ficarra, A. Frassoldati, R. D'Amico, S. Giovannelli, A. Maiorana, G. Jovic, P. Conte

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Preoperative chemotherapy (PCT) allows for in vivo testing of treatment effects on tumor and its microenvironment. Aim of this analysis was to evaluate the effect of PCT on tumor biomarker expression and to evaluate the prognostic role of treatment-induced variation of these biomarkers (molecular response). Methods: Two hundred and twenty-one stage II-III breast cancer patients were included. The following parameters were evaluated at baseline and on surgical specimens after PCT: Estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2), Ki-67, p53, human epidermal growth factor receptor (EGFR), vascular endothelial growth factor receptor 2 (VEGFR2), and apoptosis. Results: A pathological complete response was observed in 8.8% of the patients. PCT induced a significant reduction in the expression of ER, PgR, Ki-67, and apoptosis. As by multivariable model, Ki-67 ≥15% and nodal positivity after preoperative chemotherapy (PCT) were significant predictors of worse disease-free survival [hazard ratio (HR) 3.79, P <0.0001 and HR 2.31, P = 0.037, respectively]. Ki-67 ≥15% after PCT was also a significant predictor of overall survival (HR 3.75, P = 0.013). On the basis of these two parameters, patients were classified into three groups: (i) low risk (negative nodes and Ki-67

Original languageEnglish
Pages (from-to)1193-1198
Number of pages6
JournalAnnals of Oncology
Volume20
Issue number7
DOIs
Publication statusPublished - 2009

Keywords

  • Breast cancer
  • Ki-67
  • Predictive factors
  • Primary systemic therapy
  • Prognostic factors
  • Tumor biomarkers

ASJC Scopus subject areas

  • Oncology
  • Hematology

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