The changing importance of prognostic factors in breast cancer during long‐term follow‐up

Abstract

A cohort of 464 breast-cancer patients were followed up for over 10 years and the clinical, histological and morphometric factors were related to survival within different time periods during follow-up. Tumor diameter, axillary lymph-node status (pN), tubule formation and the fraction of intraductal growth as determined from the primary tumor biopsy specimen had prognostic value up to 5 years. Histological grade, morphometric nuclear factors and the M/V index had only short-term prognostic value immediately after the primary therapy. In axillary lymph-node-negative (ANN) tumors tubule formation, intraductal growth, tumor necrosis and tumor diameter had prognostic value during the first 3 postoperative years. In axillary lymph-node-positive (ANP) tumors, tumor diameter, intraductal growth and tubule formation had long-term prognostic value whereas the M/V index had prognostic value only for 1 postoperative year. Tumor diameter, axillary lymph-node status, tubule formation and the proportion of intraductal growth also had independent long-term prognostic value in a multivariate analysis and accordingly these factors can categorize breast-cancer patients into prognostic groups after several years of follow-up. In contrast, mitotic frequency loses its prognostic power within 2 postoperative years, while morphometric nuclear factors and histological grade have no practical prognostic value after 1 year of follow-up.

Dietary factors and survival from breast cancer

“…20, No. 2 estrogen receptor-positive tumors) and obesity (increasing risk of death with increasing Quetelet index) are consistent with those from previous studies (20)(21)(22). Nevertheless, our results might reflect the effects of bias from several sources, including nonresponse in the original case-control study, misclassification of exposure resulting from use of the food frequency questionnaire, and loss to follow-up.…”

Time-varying prognostic impact of tumour biological factors urokinase (uPA), PAI-1 and steroid hormone receptor status in primary breast cancer

“…The Cox proportional hazards model is based on the assumption that the relative risk (RR) associated with a factor x compared with a factor value x = 0 is described by RR(x) = exp(,x), with the coefficient independent of time. Prognostic factors may, however, have a changing influence on disease-free or overall survival probability with time (Gray, 1992;Lipponen et al, 1992;Yoshimoto et al, 1993). To reveal the time-varying effect of uPA, PAI-1, the steroid hormone receptor status and the axillary lymph node status on breast cancer prognosis, the extended Cox proportional hazards model of Gray was applied.…”

Long‐term survival data and prognostic factors of a complete response to chemotherapy in patients with head and neck cancer treated with platinum‐based induction chemotherapy: A hellenic co‐operative oncology group study

“…We have previously evaluated and published various characteristics of 115 patients with HNC for their correlation with the achievement of a CR to chemotherapy and with improved survival [18]. Since, it has been reported for breast cancer that there is a changing importance of several prognostic factors during long-term follow-up [19], we have tested if this holds true for head and neck cancer as well. Therefore, we report our findings in 154 HNC patients with a minimum follow-up for surviving patients of 5 years.…”