Disseminated tumor cells in the bone marrow of patients with operable primary breast cancer: prognostic impact in immunophenotypic subgroups and clinical implication for bisphosphonate treatment
Background Disseminated tumor cells (DTC) in the bone marrow (BM) of primary breast cancer (BC) patients are a promising surrogate marker of micrometastatic spread and an independent predictor of poor prognosis for disease-free survival (DFS) and overall survival (OS). The present study aims to anal...
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| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2016
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| In: |
Annals of surgical oncology
Year: 2016, Volume: 23, Issue: 3, Pages: 757-766 |
| ISSN: | 1534-4681 |
| DOI: | 10.1245/s10434-015-4895-3 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1245/s10434-015-4895-3
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| Author Notes: | Stefan Stefanovic, MD, Ingo Diel, MD, Peter Sinn, MD, Stefan Englert, PhD, Andre Hennigs, MD, Christine Mayer, MD, Sarah Schott, MD, Markus Wallwiener, MD, Maria Blumenstein, MD, Michael Golatta, MD, Joerg Heil, MD, Joachim Rom, MD, Christof Sohn, MD, Andreas Schneeweiss, MD, Florian Schuetz, MD, and Christoph Domschke, MD |
| Summary: | Background Disseminated tumor cells (DTC) in the bone marrow (BM) of primary breast cancer (BC) patients are a promising surrogate marker of micrometastatic spread and an independent predictor of poor prognosis for disease-free survival (DFS) and overall survival (OS). The present study aims to analyze DTCs as an independent prognostic factor for DFS/OS in tumor biology and bisphosphonate treatment.MethodsA total of 504 patients with operable primary BC and a median observation time of 72.3 months [lower quartile (LQ) 58.1; upper quartile (UQ) 82.8] have been included. DTCs were detected via immunohistochemistry as MUC-1 positive cells in the BM of 59.13 % (298 of 504) of the patients. The immunophenotyping of cancer cells was achieved immunohistochemically as well.ResultsFor luminal A/B carcinoma patients, we observed a significant benefit of BM DTC negativity with respect to DFS (luminal A, P = 0.0498; luminal B, P = 0.0224). In triple-negative patients, DTC-negative BM was associated with a longer OS (P = 0.0326). In a multivariate Cox survival analysis relating to DFS and OS, the DTC status was identified as an independent prognostic factor for DFS in luminal A/B BC (P = 0.0071). A multivariate Cox survival analysis among DTC-positive patients with luminal immunophenotype showed bisphosphonate application (P = 0.0326) to be an independent prognostic factor for DFS.ConclusionsThe findings of our multivariate analyses reveal BM DTC positivity as an independent risk factor for DFS particularly in luminal A/B BC patients. This might be a novel criterion for the identification of candidates most likely to benefit from additional adjuvant therapy possibly including bisphosphonates. |
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| Item Description: | First online: 14 October 2015 Gesehen am 22.05.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1534-4681 |
| DOI: | 10.1245/s10434-015-4895-3 |