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Prognostic impact of AJCC response criteria for neoadjuvant chemotherapy in stage II/III breast cancer patients: breast cancer subtype analyses

Cited 6 time in Web of Science Cited 7 time in Scopus
Authors
Yang, Yaewon; Im, Seock-Ah; Keam, Bhumsuk; Lee, Kyung‑Hun; Kim, Tae‑Yong; Suh, Koung Jin; Ryu, Han Suk; Moon, Hyeong-Gon; Han, Sae‑Won; Oh, Do‑Youn; Han, Wonshik; Kim, Tae‑You; Park, In Ae; Noh, Dong-Young
Issue Date
2016-07-21
Publisher
BioMed Central
Citation
BMC Cancer, 16(1):515
Keywords
Stage II or IIIBreast neoplasmNeoadjuvant chemotherapyAmerican Joint Committee on Cancer (AJCC) responseRelapse-free survivalBreast cancer subtype
Description
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Abstract
Background
Neoadjuvant chemotherapy (NAC) is a standard treatment for stage II/III breast cancer patients, and response to NAC is a useful prognostic marker. Since its introduction, 6–8 cycles of NAC has become the standard regimen to improve the outcome of these patients. The purpose of this study is to evaluate the prognostic impact of the American Joint Committee on Cancer (AJCC) response criteria and this tool’s usefulness in four different breast cancer subtypes.

Methods
We conducted a retrospective cohort study of clinical stage II/III breast cancer patients who received NAC of more than 6 cycles. Response after NAC and the clinicopathological factors were reviewed. AJCC response criteria for NAC were adopted from the AJCC Manual, 7th edition: complete response (CR), partial response (PR), and no response (NR).

Results
A total of 183 patients were enrolled; 22 (12.0 %), 123 (67.2 %), and 38 (20.8 %) patients showed CR, PR, and NR, respectively. The AJCC response was significantly associated with relapse-free survival (RFS) (P < 0.001), whereas pathologic CR (pCR), the current gold standard for response evaluation for NAC, was not (P = 0.140). AJCC response was a significant prognostic factor for RFS in all four breast cancer subtypes, namely luminal A (P = 0.006), luminal B (P = 0.001), HER-2 enriched (P = 0.039), and triple-negative breast cancer (P = 0.035).

Conclusions
The AJCC response criteria represent a simple and easily reproducible tool for response evaluation of NAC patients and a useful clinical prognostic marker for RFS. These criteria also have a prognostic impact in all four breast cancer subtypes, including luminal A in which pCR has a limited role.
Language
English
URI
http://hdl.handle.net/10371/100541
DOI
https://doi.org/10.1186/s12885-016-2500-1
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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