Background: Peritumoral vascular invasion (PVI) may assist in assigning optimal adjuvant systemic therapy for women with early breast cancer. Patients and methods: Patients participated in two International Breast Cancer Study Group randomized trials testing chemoendocrine adjuvant therapies in premenopausal (trial VIII) or postmenopausal (trial IX) node-negative breast cancer. PVI was assessed by institutional pathologists and/or central review on hematoxylin-eosin-stained slides in 99% of patients (analysis cohort 2754 patients, median follow-up >9 years). Results: PVI, present in 23% of the tumors, was associated with higher grade tumors and larger tumor size (trial IX only). Presence of PVI increased locoregional and distant recurrence and was significantly associated with poorer disease-free survival. The adverse prognostic impact of PVI in trial VIII was limited to premenopausal patients with endocrine-responsive tumors randomized to therapies not containing goserelin, and conversely the beneficial effect of goserelin was limited to patients whose tumors showed PVI. In trial IX, all patients received tamoxifen: the adverse prognostic impact of PVI was limited to patients with receptor-negative tumors regardless of chemotherapy. Conclusion: Adequate endocrine adjuvant therapy appears to abrogate the adverse impact of PVI in node-negative disease, while PVI may identify patients who will benefit particularly from adjuvant therapy.
Adverse prognostic value of peritumoral vascular invasion: is it abrogated by adequate endocrine adjuvant therapy? Results from two International Breast Cancer Study Group randomized trials of chemoendocrine adjuvant therapy for early breast cancer / G. Viale, A. Giobbie-Hurder, B.A. Gusterson, E. Maiorano, M.G. Mastropasqua, A. Sonzogni, E. Mallon, M. Colleoni, M. Castiglione-Gertsch, M.M. Regan, K.N. Price, R.W. Brown, R. Golouh, D. Crivellari, P. Karlsson, C. Ohlschlegel, R.D. Gelber, A. Goldhirsch, A.S. Coates. - In: ANNALS OF ONCOLOGY. - ISSN 0923-7534. - 21:21(2010), pp. 245-254.
|Titolo:||Adverse prognostic value of peritumoral vascular invasion: is it abrogated by adequate endocrine adjuvant therapy? Results from two International Breast Cancer Study Group randomized trials of chemoendocrine adjuvant therapy for early breast cancer|
VIALE, GIUSEPPE (Primo)
|Parole Chiave:||Adjuvant therapy; Breast cancer; Endocrine responsiveness; Metastasis; Prognosis; Vascular invasion|
|Settore Scientifico Disciplinare:||Settore MED/08 - Anatomia Patologica|
|Data di pubblicazione:||2010|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1093/annonc/mdp317|
|Appare nelle tipologie:||01 - Articolo su periodico|