Biological considerations in locally advanced breast cancer treated with anthracycline-based neoadjuvant chemotherapy : thymidine labelling index is an independent indicator of clinical outcome

• Published in: Breast cancer research and treatment Vol. 68; no. 2; pp. 147 - 157
• Main Authors: OZMEN, Vahit, CABIOGLU, Neslihan, DOLAY, Kemal, BILIR, Ayhan, KECER, Mustafa, AVDINER, Adnan, MUSLUMANOGLU, Mahmut, IGCI, Abdullah, BOZFAKIOGLU, Yavuz, DAGOGLU, Temel
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.07.2001; Springer Nature B.V
• Subjects: Adult; Aged; Antibiotics, Antineoplastic - therapeutic use; Antineoplastic agents; Antineoplastic Agents - therapeutic use; Axilla; Biological and medical sciences; Breast cancer; Breast Neoplasms - genetics; Breast Neoplasms - metabolism; Breast Neoplasms - therapy; Cancer research; Cancer therapies; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); DNA, Neoplasm - analysis; Female; Follow-Up Studies; Humans; Lymph Nodes - pathology; Medical sciences; Microfilament Proteins - metabolism; Middle Aged; Muscle Proteins; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm Staging; Pharmacology. Drug treatments; Prognosis; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Retrospective Studies; Thymidine - metabolism; Antineoplastic agent; Human; Relapse; Toxicity; Estrogen; Tumoral marker; Thymidine; Malignant tumor; Radiotherapy; Survival; Mammary gland diseases; Chemotherapy; Surgery; Female; Advanced stage; Anthracyclins; Combined treatment; Mammary gland; Progesterone; Preoperative; Hormonal receptor
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1023/A:1011956502082

The present retrospective study aims to determine the clinical value of thymidine labelling index (TLI) together with other established clinical and biological factors in 116 locally advanced breast cancer (LABC) patients treated with anthracycline-based neoadjuvant chemotherapy, surgery, adjuvant chemotherapy and radiotherapy. TLI was determined in 71 LABC patients with a median of 2.62% (0-23.64%) and a mean of 4.71% +/- 5.54. As a result of neoadjuvant chemotherapy, 85 patients (73%) responded to chemotherapy (CT), whereas 31 patients were unresponsive (27%). No relationship has been found between the pretreatment biological variables including TLI, estrogen receptor (ER), progesteron receptor (PgR) status and clinical parameters such as the chemotherapy response rates and axillary lymph node involvement following chemotherapy. Median follow-up was 35 months (18-97 months) and the 3-year overall survival (OS) and disease free survival (DFS) rates were 71.6% and 52.2%, respectively. In univariate analysis, patients with inflammatory breast cancer, high TLI-index (> or = 2.62%), lymph node (LN) positivity or > 3 positive lymph nodes following neoadjuvant chemotherapy and without any response to neoadjuvant chemotherapy were found to have worse DFS and OS-rates and high local and systemic recurrence rates. In multivariate analysis, TLI was estimated as the most powerful independent factor affecting the OS in LABC patients among the other established clinical and biological parameters (p = 0.02). These results suggest that TLI is an important independent indicator of clinical outcome in patients with LABC and these patients with high TLI levels require more effective treatment modalities.