In order to identify biomarkers associated with outcome in the CCIH cohort, Cox proportional hazard analysis was used to identify the subset of these thirty-seven markers that had a univariate association of IHC staining with recurrence-free interval (distant and local recurrence) at 5 years.
Multivariate analysis showed that tumor depth (p = 0.040) and lymph node metastasis (p = 0.013) remained independent prognostic factors for LRFS (Table 2).> -wrap-foot> notnot significant, HR hazard ratios, 95 % CI 95%% confidence interval Distant metastases occurred in 32 (73 %) patients.
A high level of uPA was also related to a shorter disease-free interval and distant recurrence-free interval.
In univariate analysis, high levels of uPA and p53 were associated with shorter disease-specific survival, disease-free interval, and distant recurrence-free interval.
1– 5 Refractory lesions are often highly unpleasant for the patient; can lead to ulceration, bleeding, or infection; and can affect extensive areas for prolonged intervals before distant metastasis.
The prognosis signature is superior to currently available clinical and histopathological prognostic factors in predicting a short interval to distant metastases (odds ratio = 18[95%% confidence interval = 3.3-94], P < 0.001, multivariate analysis).
In the context of breast cancer, whole genome approaches have identified prognostic gene sets that predict a short interval to distant metastases (i.e. a poor prognosis signature; [5], [6], [7]) and described gene profiles that mediate metastasis to a secondary site [8], [9], [10].
HER2-overexpressed tumors are known to progress rapidly and have a short interval to distant metastases [ 6].
We have defined a gene expression profile of 70 genes that is predictive for a short interval to distant metastases.
BC1: First breast cancer; BC2: Second breast cancer; CBC: Contralateral breast cancer; CI: Confidence interval; DDFS: Distant disease-free survival; HR: Hazard ratio; IQR: interquartile range.
