Περίληψη:
Background: We investigated the impact of follow-up duration to
determine whether two immunohistochemical prognostic panels, IHC4 and
Mammostrat, provide information on the risk of early or late distant
recurrence using the Edinburgh Breast Conservation Series and the
Tamoxifen vs Exemestane Adjuvant Multinational (TEAM) trial.
Methods: The multivariable fractional polynomial time (MFPT) algorithm
was used to determine which variables had possible nonproportional
effects. The performance of the scores was assessed at various lengths
of follow-up and Cox regression modelling was performed over the
intervals of 0- 5 years and 45 years.
Results: We observed a strong time dependence of both the IHC4 and
Mammostrat scores, with their effects decreasing over time. In the first
5 years of follow- up only, the addition of both scores to clinical
factors provided statistically significant information (Po0.05), with
increases in R-2 between 5 and 6% and increases in D-statistic between
0.16 and 0.21.
Conclusions: Our analyses confirm that the IHC4 and Mammostrat scores
are strong prognostic factors for time to distant recurrence but this is
restricted to the first 5 years after diagnosis. This provides evidence
for their combined use to predict early recurrence events in order to
select those patients who may/will benefit from adjuvant chemotherapy.
Συγγραφείς:
Stephen, J.
Murray, G.
Cameron, D. A.
Thomas, J. and
Kunkler, I. H.
Jack, W.
Kerr, G. R.
Piper, T.
Brookes,
C. L.
Rea, D. W.
van de Velde, C. J. H.
Hasenburg, A. and
Markopoulos, C.
Dirix, L.
Seynaeve, C.
Bartlett, J. M. S.
