Prolonged disease-free survival after one course of perioperative adjuvant chemotherapy for node-negative breast cancer

A. Goldhirsch, B. Davis, R. Bettelheim, W. Hartmann, M. Neville, M. Castiglione, A. Pedrazzini, D. Zava, C. Wiedmer, R. D. Gelber, K. Price, K. Stanley, N. Snudden, M. Zelen, M. Isley, M. Parsons, L. Szymoniak, R. G. Kay, J. Probert

Research output: Contribution to journalArticle

Abstract

We compared a single perioperative cycle of adjuvant combination chemotherapy with no adjuvant treatment in a randomized trial (Ludwig Trial V) including 1275 patients with breast cancer who had no axillary-node metastases. The chemotherapy was administered on days 1 and 8, beginning within 36 hours after mastectomy, and consisted of cyclophosphamide, methotrexate, fluorouracil, and leucovorin. At a median follow-up of 42 months, the mean four-year disease-free survival (± SE) was 77 ± 2 percent among the patients who received chemotherapy perioperatively, as compared with 73 ± 2 percent among the patients who received no adjuvant treatment (hazard ratio, 0.77; 95 percent confidence interval, 0.61 to 0.98; P = 0.04). An advantage was observed for both premenopausal women. The magnitude of the treatment effect was largest among patients with no or low estrogen-receptor content in the primary tumor. We conclude that chemotherapy modifies the postoperative course of node-negative breast cancer. Further trials to investigate an optimal selection of patients and treatments should be regarded as the best available therapeutic approach.

Original languageEnglish
Pages (from-to)491-496
Number of pages6
JournalNew England Journal of Medicine
Volume320
Issue number8
Publication statusPublished - 1989

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Prolonged disease-free survival after one course of perioperative adjuvant chemotherapy for node-negative breast cancer'. Together they form a unique fingerprint.

  • Cite this

    Goldhirsch, A., Davis, B., Bettelheim, R., Hartmann, W., Neville, M., Castiglione, M., Pedrazzini, A., Zava, D., Wiedmer, C., Gelber, R. D., Price, K., Stanley, K., Snudden, N., Zelen, M., Isley, M., Parsons, M., Szymoniak, L., Kay, R. G., & Probert, J. (1989). Prolonged disease-free survival after one course of perioperative adjuvant chemotherapy for node-negative breast cancer. New England Journal of Medicine, 320(8), 491-496.