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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.
BMC Cancer. 2007 Apr 12; 7:63.BC

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.

Authors+Show Affiliations

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. cutekhlee@freechal.com <cutekhlee@freechal.com>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17430582

Citation

Lee, Kyung-Hun, et al. "Prognostic Significance of Bcl-2 Expression in Stage III Breast Cancer Patients Who Had Received Doxorubicin and Cyclophosphamide Followed By Paclitaxel as Adjuvant Chemotherapy." BMC Cancer, vol. 7, 2007, p. 63.
Lee KH, Im SA, Oh DY, et al. Prognostic significance of bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy. BMC Cancer. 2007;7:63.
Lee, K. H., Im, S. A., Oh, D. Y., Lee, S. H., Chie, E. K., Han, W., Kim, D. W., Kim, T. Y., Park, I. A., Noh, D. Y., Heo, D. S., Ha, S. W., & Bang, Y. J. (2007). Prognostic significance of bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy. BMC Cancer, 7, 63.
Lee KH, et al. Prognostic Significance of Bcl-2 Expression in Stage III Breast Cancer Patients Who Had Received Doxorubicin and Cyclophosphamide Followed By Paclitaxel as Adjuvant Chemotherapy. BMC Cancer. 2007 Apr 12;7:63. PubMed PMID: 17430582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic significance of bcl-2 expression in stage III breast cancer patients who had received doxorubicin and cyclophosphamide followed by paclitaxel as adjuvant chemotherapy. AU - Lee,Kyung-Hun, AU - Im,Seock-Ah, AU - Oh,Do-Youn, AU - Lee,Se-Hoon, AU - Chie,Eui Kyu, AU - Han,Wonshik, AU - Kim,Dong-Wan, AU - Kim,Tae-You, AU - Park,In Ae, AU - Noh,Dong-Young, AU - Heo,Dae Seog, AU - Ha,Sung Whan, AU - Bang,Yung-Jue, Y1 - 2007/04/12/ PY - 2006/11/16/received PY - 2007/04/12/accepted PY - 2007/4/14/pubmed PY - 2007/5/12/medline PY - 2007/4/14/entrez SP - 63 EP - 63 JF - BMC cancer JO - BMC Cancer VL - 7 N2 - 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. SN - 1471-2407 UR - https://www.unboundmedicine.com/medline/citation/17430582/Prognostic_significance_of_bcl_2_expression_in_stage_III_breast_cancer_patients_who_had_received_doxorubicin_and_cyclophosphamide_followed_by_paclitaxel_as_adjuvant_chemotherapy_ L2 - https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-7-63 DB - PRIME DP - Unbound Medicine ER -