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Prognostic significance of bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy.

Lee KH, Im SA, Oh DY, Lee SH, Chie EK, Han W, Kim DW, Kim TY, Park IA, Noh DY, Heo DS, Ha SW, Bang YJ - BMC Cancer (2007)

Bottom Line: Moreover, ER positivity (P = 0.013), bcl-2 positivity (P = 0.002) and low p53 expression (P = 0.032) were found to be significantly associated with a prolonged DFS.In addition, bcl-2 expression was found to be significantly correlated with the expressions of ER and PR, and inversely correlated with the expressions of p53, c-erbB2 and Ki-67.Moreover, OS was significantly affected by ER, bcl-2 and c-erbB2.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. cutekhlee@freechal.com <cutekhlee@freechal.com>

ABSTRACT

Background: Bcl-2 is positively regulated by hormonal receptor pathways in breast cancer. A study was conducted to assess the prognostic significances of clinico-pathologic variables and of ER, PR, p53, c-erbB2, bcl-2, or Ki-67 as markers of relapse in breast cancer patients who had received the identical adjuvant therapy at a single institution.

Methods: A cohort of 151 curatively resected stage III breast cancer patients (M:F = 3:148, median age 46 years) who had 4 or more positive lymph nodes and received doxorubicin and cyclophosphamide followed by paclitaxel (AC/T) as adjuvant chemotherapy was analyzed for clinico-pathologic characteristics including disease-free survival (DFS) and overall survival (OS). Patients with positive ER and/or PR expression received 5 years of tamoxifen following AC/T. The protein expressions of biomarkers were assessed immunohistochemically.

Results: The median follow-up duration was 36 months, and 37 patients (24.5%) experienced a recurrence. Univariate analyses indicated that the tumor size (P = 0.038) and the number of involved lymph nodes (P < 0.001) significantly affected the recurrences. However, the type of surgery, the histology, histologic grade, the presence of endolymphatic emboli, and a close resection margin did not. Moreover, ER positivity (P = 0.013), bcl-2 positivity (P = 0.002) and low p53 expression (P = 0.032) were found to be significantly associated with a prolonged DFS. Furthermore, multivariate analysis identified 10 or more involved lymph nodes (HR 7.366; P < 0.001), negative bcl-2 expression (HR 2.895; P = 0.030), and c-erbB2 over-expression (HR 3.535; P = 0.001) as independent indicators of poorer DFS. In addition, bcl-2 expression was found to be significantly correlated with the expressions of ER and PR, and inversely correlated with the expressions of p53, c-erbB2 and Ki-67. Patients with bcl-2 expression had a significantly longer DFS than those without, even in the ER (+) subgroup. Moreover, OS was significantly affected by ER, bcl-2 and c-erbB2.

Conclusion: Bcl-2 is an independent prognostic factor of DFS in curatively resected stage III breast cancer patients and appears to be a useful prognostic factor in combination with c-erbB2 and the number of involved lymph nodes.

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Disease-free survival according to bcl-2 status in (A) ER-positive and (B) ER-negative pateints. Bcl-2 (+) patients showed better disease-free survival even in those with an ER (+) status, suggesting that bcl-2 has a prognostic role that is independent of ER expression.
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Figure 2: Disease-free survival according to bcl-2 status in (A) ER-positive and (B) ER-negative pateints. Bcl-2 (+) patients showed better disease-free survival even in those with an ER (+) status, suggesting that bcl-2 has a prognostic role that is independent of ER expression.

Mentions: Because bcl-2 was found to be strongly correlated with ER expression, ER (+) and ER (-) subgroups were analyzed separately for DFS according to bcl-2 status. In 83 patients with ER (+) tumors, 7 patients had tumors not expressing bcl-2 and these patients had a significantly shorter DFS. However, in the ER (-) subgroup no significant differences were found on DFS according to bcl-2 status (Figure 2).


Prognostic significance of bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy.

Lee KH, Im SA, Oh DY, Lee SH, Chie EK, Han W, Kim DW, Kim TY, Park IA, Noh DY, Heo DS, Ha SW, Bang YJ - BMC Cancer (2007)

Disease-free survival according to bcl-2 status in (A) ER-positive and (B) ER-negative pateints. Bcl-2 (+) patients showed better disease-free survival even in those with an ER (+) status, suggesting that bcl-2 has a prognostic role that is independent of ER expression.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1863427&req=5

Figure 2: Disease-free survival according to bcl-2 status in (A) ER-positive and (B) ER-negative pateints. Bcl-2 (+) patients showed better disease-free survival even in those with an ER (+) status, suggesting that bcl-2 has a prognostic role that is independent of ER expression.
Mentions: Because bcl-2 was found to be strongly correlated with ER expression, ER (+) and ER (-) subgroups were analyzed separately for DFS according to bcl-2 status. In 83 patients with ER (+) tumors, 7 patients had tumors not expressing bcl-2 and these patients had a significantly shorter DFS. However, in the ER (-) subgroup no significant differences were found on DFS according to bcl-2 status (Figure 2).

Bottom Line: Moreover, ER positivity (P = 0.013), bcl-2 positivity (P = 0.002) and low p53 expression (P = 0.032) were found to be significantly associated with a prolonged DFS.In addition, bcl-2 expression was found to be significantly correlated with the expressions of ER and PR, and inversely correlated with the expressions of p53, c-erbB2 and Ki-67.Moreover, OS was significantly affected by ER, bcl-2 and c-erbB2.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. cutekhlee@freechal.com <cutekhlee@freechal.com>

ABSTRACT

Background: Bcl-2 is positively regulated by hormonal receptor pathways in breast cancer. A study was conducted to assess the prognostic significances of clinico-pathologic variables and of ER, PR, p53, c-erbB2, bcl-2, or Ki-67 as markers of relapse in breast cancer patients who had received the identical adjuvant therapy at a single institution.

Methods: A cohort of 151 curatively resected stage III breast cancer patients (M:F = 3:148, median age 46 years) who had 4 or more positive lymph nodes and received doxorubicin and cyclophosphamide followed by paclitaxel (AC/T) as adjuvant chemotherapy was analyzed for clinico-pathologic characteristics including disease-free survival (DFS) and overall survival (OS). Patients with positive ER and/or PR expression received 5 years of tamoxifen following AC/T. The protein expressions of biomarkers were assessed immunohistochemically.

Results: The median follow-up duration was 36 months, and 37 patients (24.5%) experienced a recurrence. Univariate analyses indicated that the tumor size (P = 0.038) and the number of involved lymph nodes (P < 0.001) significantly affected the recurrences. However, the type of surgery, the histology, histologic grade, the presence of endolymphatic emboli, and a close resection margin did not. Moreover, ER positivity (P = 0.013), bcl-2 positivity (P = 0.002) and low p53 expression (P = 0.032) were found to be significantly associated with a prolonged DFS. Furthermore, multivariate analysis identified 10 or more involved lymph nodes (HR 7.366; P < 0.001), negative bcl-2 expression (HR 2.895; P = 0.030), and c-erbB2 over-expression (HR 3.535; P = 0.001) as independent indicators of poorer DFS. In addition, bcl-2 expression was found to be significantly correlated with the expressions of ER and PR, and inversely correlated with the expressions of p53, c-erbB2 and Ki-67. Patients with bcl-2 expression had a significantly longer DFS than those without, even in the ER (+) subgroup. Moreover, OS was significantly affected by ER, bcl-2 and c-erbB2.

Conclusion: Bcl-2 is an independent prognostic factor of DFS in curatively resected stage III breast cancer patients and appears to be a useful prognostic factor in combination with c-erbB2 and the number of involved lymph nodes.

Show MeSH
Related in: MedlinePlus