Details

Autor(en) / Beteiligte

• Jones, Robin L
• Salter, Janine
• A'Hern, Roger
• Nerurkar, Ash
• Parton, Marina
• Reis-Filho, Jorge S
• Smith, Ian E
• Dowsett, Mitchell

Titel

prognostic significance of Ki67 before and after neoadjuvant chemotherapy in breast cancer

Ist Teil von

• Breast cancer research and treatment, 2009-07, Vol.116 (1), p.53-68

Ort / Verlag

Boston: Boston : Springer US

Erscheinungsjahr

2009

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose To compare the prognostic significance of proliferation, as assessed by Ki67 expression, in breast cancer before and after neoadjuvant chemotherapy. Methods A retrospective search of a prospectively maintained clinical database was performed to identify patients treated with neoadjuvant chemotherapy at the Royal Marsden Hospital. The expression of Ki67 was assessed using immunohistochemistry in pre-therapy core-needle biopsy and post-therapy surgical excision specimens. The following factors were considered pre- and post-chemotherapy for their relationship with relapse-free and overall survival: age, menstrual status, T and N stage, pre-therapy operability, Ki67, ER, PgR, HER2, grade, histological subtype, vascular invasion, clinical response, chemotherapy regimen, type of surgery performed, adjuvant therapy, pathological tumour size and nodal involvement. Results In a matched cohort of 103 patients, on multivariate analysis of relapse-free survival, post-therapy Ki67 was the only significant independent prognostic factor. On multivariate analysis for overall survival, both pre- and excision Ki67 were significant independent predictors but the latter showed a stronger prognostic impact. The highest and lowest tertiles of excision Ki67 had different prognosis for both 5-year relapse-free (27% vs. 77%) and overall (39% and 93%) survival. In a cohort of 284 patients with only excision samples, post-therapy Ki67 was a significant independent prognostic factor on multivariate analysis. Conclusion Post-chemotherapy Ki67 is a strong predictor of outcome for patients not achieving a pathological complete response.