Prognostic significance of three novel biologic factors in a clinical trial of adjuvant therapy for node-negative breast cancer.

Abstract

BACKGROUND:

Five products of human breast carcinoma cells, including membrane-associated phospholipase A2 (M-PLA2), polymorphonuclear leukocyte elastase (PMN-E), tissue-type plasminogen activator (t-PA), urokinase-type plasminogen activator (u-PA), and endothelin-1 (ET-1), have been implicated in the processes of tumor cell invasion and metastasis in human breast carcinoma. However, the prognostic significance of these factors has not been assessed previously in node-negative breast carcinoma, in which adjuvant treatment is dependent on risk stratification.

METHODS:

The five products of breast carcinoma cells were measured in 184 patients with node-negative breast carcinoma who were enrolled in the Kumamoto Adjuvant Chemo-Endocrine Therapy for Breast Cancer prospective randomized trial, and the predictive values of these factors for relapse-free and overall survival were evaluated.

RESULTS:

M-PLA2, PMN-E, and t-PA were found to be significant independent predictors of relapse-free and overall survival, whereas u-PA and ET-1 were not independently predictive. Further statistical analyses showed that the predictive powers of M-PLA2, PMN-E, and t-PA were additive. A combination of these three factors identified a group of patients (approximately 50% of those who manifested node-negative breast carcinoma) with a favorable prognosis, regardless of the administration of adjuvant therapy.

CONCLUSIONS:

This study identified three biologic factors that are valuable predictors of survival in node-negative breast carcinoma. A combination of these biologic factors may allow identification of low-risk patients who could be spared adjuvant therapy.

• Authors: J Yamashita, M Ogawa, K Sakai
• Journal: Surgery (Surgery) Vol. 117 Issue 6 Pg. 601-8 (Jun 1995) ISSN: 0039-6060 [Print] United States
• PMID: 7778023 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Endothelins
• Tamoxifen
• Phospholipases A
• Phospholipases A2
• Pancreatic Elastase
• Leukocyte Elastase
• Tissue Plasminogen Activator
• Urokinase-Type Plasminogen Activator

Topics

• Breast Neoplasms (chemistry, drug therapy, pathology)
• Carcinoma (chemistry, drug therapy, pathology)
• Chemotherapy, Adjuvant
• Disease-Free Survival
• Endothelins (analysis)
• Female
• Follow-Up Studies
• Humans
• Leukocyte Elastase
• Mastectomy, Modified Radical
• Mastectomy, Radical
• Neoplasm Staging
• Pancreatic Elastase (analysis)
• Phospholipases A (analysis)
• Phospholipases A2
• Prognosis
• Prospective Studies
• Risk Factors
• Survival Rate
• Tamoxifen (therapeutic use)
• Tissue Plasminogen Activator (analysis)
• Urokinase-Type Plasminogen Activator (analysis)