Is the thymidine labeling index a good prognostic marker in breast cancer?

Sen-Oran Ebru, Ozmen Vahit, Bilir Ayhan, Cabioglu Neslihan, Muslumanoglu Mahmut, Igci Abdullah, Guney Nese, Kecer, Kecer Mustafa

Description

The aim of the present study was to determine the prognostic relevance of thymidine labeling index (TLI) in patients with breast cancer. Methods TLI of the primary tumor was measured in 268 patients at the time of the surgical biopsy by an in vitro method. Results Fifty-four patients had stage I disease, and 138 patients had stage II disease, and 76 patients had stage III disease. One hundred-four patients were found to have low TLI-index (<3%), and 164 patients had high TLI-index (≥3%). The median follow-up was 71.5 months (range, 6–138 months). The 5-year overall survival (OS) and disease free survival (DFS) rates was 84% and 74%, respectively. Lymph node involvement, tumor size more than 2 cm, high nuclear grade and estrogen receptor negativity were found to be associated with poorer DFS and OS rates. On subgroup analysis, however, the 5-year OS rate was significantly higher in the low TLI-group than in the high TLI-group in patients with stage I disease (100% vs 76%, p = 0.05). Conclusion Our findings suggest that the prognostic significance of TLI appears to be limited to early breast cancer that might help to distinguish patients who need more aggressive adjuvant treatment.

Informations

• Publié par: biomed
• Publié le: 01 janvier 2007
• Nombre de lectures: 26
• Langue: English

Extrait

World Journal of Surgical Oncology

BioMedCentral

Open Access Research Is the thymidine labeling index a good prognostic marker in breast cancer? 1,4 12 1 Ebru SenOran*, Vahit Ozmen, Ayhan Bilir, Neslihan Cabioglu, 1 13 1 Mahmut Muslumanoglu, Abdullah Igci, Nese Guneyand Mustafa Kecer

1 2 Address: Departmentsof General Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey,Department of Histology and 3 Embryology, Istanbul Medical School, Istanbul University, Istanbul, Turkey,Department of Oncology, Istanbul Medical School, Istanbul 4 University, Istanbul, Turkey andDepartment of Surgery, Memorial Hospital, Istanbul, Turkey Email: Ebru SenOran*  [e-mail]; Vahit Ozmen  [e-mail]; Ayhan Bilir  [e-mail]; Neslihan Cabioglu  [e-mail]; Mahmut Muslumanoglu  [e-mail]; Abdullah Igci  [e-mail]; Nese Guney  [e-mail]; Mustafa Kecer  [e-mail] * Corresponding author

Published: 19 August 2007Received: 4 February 2007 Accepted: 19 August 2007 World Journal of Surgical Oncology2007,5:93 doi:10.1186/1477-7819-5-93 This article is available from: http://www.wjso.com/content/5/1/93 © 2007 Sen-Oran et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background:The aim of the present study was to determine the prognostic relevance of thymidine labeling index (TLI) in patients with breast cancer. Methods:TLI of the primary tumor was measured in 268 patients at the time of the surgical biopsy by an in vitro method. Results:Fifty-four patients had stage I disease, and 138 patients had stage II disease, and 76 patients had stage III disease. One hundred-four patients were found to have low TLI-index (<3%), and 164 patients had high TLI-index (≥3%). The median follow-up was 71.5 months (range, 6–138 months). The 5-year overall survival (OS) and disease free survival (DFS) rates was 84% and 74%, respectively. Lymph node involvement, tumor size more than 2 cm, high nuclear grade and estrogen receptor negativity were found to be associated with poorer DFS and OS rates. On subgroup analysis, however, the 5-year OS rate was significantly higher in the low TLI-group than in the high TLI-group in patients with stage I disease (100% vs 76%, p = 0.05). Conclusion:Our findings suggest that the prognostic significance of TLI appears to be limited to early breast cancer that might help to distinguish patients who need more aggressive adjuvant treatment.

Background The determination of prognosis of a patient with breast cancer is extremely important due to the complex biology of cancer. Great efforts have been made to separate patients who need agressive systemic treatment due to highrisk of recurrence, from those in whom locoregional treatment is sufficient. For this purpose, increasing

number of biological markers such as hormone receptors, bcl2, p53 mutations, cerbB2 overexpression, Ki67, nuclear DNA ploidy, and microvessel density have been proposed as potential prognostic markers in breast cancer [15]. Many of these markers appeared to be promising in initial reports but eventually failed to maintain their pre dictive value on clinical outcome. Among these markers,

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