Càncer de mama d'alt risc. Tractament adjuvant amb adriamicina-cmf. Anàlisis dels factors pronòstics
We sought to evaluate outcomes and the most likely prognostic factors associated with the use of sequential doxorubicin + cyclophosphamide-methotrexate-fluorouracil administered prior to scheduled radiation therapy, in non-selected consecutive patients (n=163) with 4 positive nodes. Vari...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2006 |
| País: | España |
| Institución: | Universitat Rovira i virgili (URV) |
| Repositorio: | Repositori Institucional de la Universitat Rovira i Virgili |
| OAI Identifier: | oai:urv.cat:TDX:496 |
| Acceso en línea: | https://hdl.handle.net/20.500.11797/TDX496 http://hdl.handle.net/10803/8717 |
| Access Level: | acceso abierto |
| Palabra clave: | 616 - Patologia. Medicina clínica. Oncologia 61 - Medicina |
| Sumario: | We sought to evaluate outcomes and the most likely prognostic factors associated with the use of sequential doxorubicin + cyclophosphamide-methotrexate-fluorouracil administered prior to scheduled radiation therapy, in non-selected consecutive patients (n=163) with 4 positive nodes. Variables included in statistical analyses included age, menopausal status, tumour size, histology grade, number of positive nodes (4 to 9 or 10), oestrogen and progesterone receptors (ER, PR), HER-2 status and chemotherapy-induced amenorrhoea. With a median follow-up of 86 months, the results showed disease-free survival (DFS) at 5 years was 68% and overall survival (OS) was 78% and no toxic deaths. Number of positive nodes, tumour size, histology grade and amenorrhoea showed prognostic significance for DFS and OS. ER and PR reached significance only for OS. HER-2 positive status did not predict poorer DFS or OS. Tumor size > 2 cm, 10+ positive nodes and grade 3 tumours predicted DFS and OS in multivariate analysis. Amenorrhoea reach prognostic significance for DFS and OS in premenopausal patients. We conclude that DOXCMF is an effective and safe regimen. Number of positive axillary nodes, histologic grade and tumor size , but not HER2 status, are predictive of outcome. Amenorrhoea favour DFS and OS in premenopausal patients. |
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