Original Article
The impacts of chemotherapeutic response for clinical stage II and III breast cancer patients after neoadjuvant chemotherapy
Abstract
Background: Neoadjuvant chemotherapy (NAC) has been an increase in the utilization of neoadjuvant treatment for invasive breast cancer over the last decade. In this study, we assess outcomes between responders and non-responders after NAC in patients with clinical stage II and III breast cancer.
Methods: In total, 133 patients with clinical stage II and III invasive breast ductal carcinoma (IDC) treated with anthracycline- or taxane-based NAC, followed by surgery and adjuvant radiotherapy between April 2007 and December 2012, were retrospectively reviewed and assigned as responders [complete or partial response (PR)] or non-responders (stable or progressive disease), based on clinical and pathological assessments.
Results: The median follow up time was 59.2 months (range, 12.3–110 months). After NAC, 89 patients were responders, whereas 44 patients were non-responders. For the responders and non-responders, overall survival (OS) was 94.5 and 78.2 months (95% CI, 89.2–99.8 and 67.0–89.4, P=0.007), and relapse-free survival (RFS) was 85.5 and 59.9 months (95% CI, 78.3–92.6 and 47.3–72.4, P<0.001), respectively. Cox models confirmed the prognostic value of human epidermal growth factor receptor 2 (HER2/neu) with overexpression [hazard ratio (HR) =0.234; 95% CI, 0.074–0.737, P=0.0013] in the multivariate analysis. However, patients that were pathologically node-positive were associated with poor OS (HR =7.126; 95% CI, 1.748–29.005, P=0.0006 in the multivariate analysis).
Conclusions: Patients with a complete or PR after NAC had improved OS and RFS. The HER2/neu-positive value may be considered to be a good prognostic factor. Further treatment for pathologically node-positive patients should be considered.
Methods: In total, 133 patients with clinical stage II and III invasive breast ductal carcinoma (IDC) treated with anthracycline- or taxane-based NAC, followed by surgery and adjuvant radiotherapy between April 2007 and December 2012, were retrospectively reviewed and assigned as responders [complete or partial response (PR)] or non-responders (stable or progressive disease), based on clinical and pathological assessments.
Results: The median follow up time was 59.2 months (range, 12.3–110 months). After NAC, 89 patients were responders, whereas 44 patients were non-responders. For the responders and non-responders, overall survival (OS) was 94.5 and 78.2 months (95% CI, 89.2–99.8 and 67.0–89.4, P=0.007), and relapse-free survival (RFS) was 85.5 and 59.9 months (95% CI, 78.3–92.6 and 47.3–72.4, P<0.001), respectively. Cox models confirmed the prognostic value of human epidermal growth factor receptor 2 (HER2/neu) with overexpression [hazard ratio (HR) =0.234; 95% CI, 0.074–0.737, P=0.0013] in the multivariate analysis. However, patients that were pathologically node-positive were associated with poor OS (HR =7.126; 95% CI, 1.748–29.005, P=0.0006 in the multivariate analysis).
Conclusions: Patients with a complete or PR after NAC had improved OS and RFS. The HER2/neu-positive value may be considered to be a good prognostic factor. Further treatment for pathologically node-positive patients should be considered.
