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Indian J Pathol Microbiol. 2018 Oct-Dec;61(4):505-509. doi: 10.4103/IJPM.IJPM_321_17.

Prognostic indices predictive of short-term disease-free survival of breast carcinoma patients receiving primary surgical treatment in Sri Lanka.

Author information

1
Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
2
Department of Pathology, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Abstract

Background:

Breast carcinoma (BCa) is the commonest malignancy among women worldwide and in Sri Lanka. Several prognostic indices are described for BCa.

Aims:

To assess clinicopathological features and prognostic indices derived from routine clinical, histopathological and immunohistochemical (IHC) data, in a cohort of patients undergoing primary surgery for BCa and to determine their prognostic impact on short-term disease free survival.

Setting and Design:

: This is a bidirectional cohort study of 208 women undergoing primary surgery for BCa at the National Hospital of Sri Lanka, from 2012-2014, excluding post-neoadjuvant chemotherapy cases.

Material and Methods:

Clinical details, tumor size and nodal status were obtained from histopathology reports. Histopathology and estrogen/progesterone receptor and HER2 status were reviewed. Molecular subtype based on IHC was determined. Nodal ratio (number of positive nodes/total number retrieved) and Nottingham prognostic index were calculated. Follow up information was obtained by patient interviews and record review.

Statistical Analysis:

Data was analyzed by univariate and multivariate Cox regression using SPSS19.0.

Results:

Mean follow-up duration was 27.16 months (0.5-52 months, s = 9.35 months). 174 (82.9%) remained disease free with 19 (9%) deaths. Thirteen (6.2%) survived with metastasis and 4 (1.9%) with recurrences. On univariate Cox regression, tumor, nodal and TNM stages, nodal ratio and lymphovascular invasion (LVI) were predictive of disease free survival (DFS) (P = 0.001, P = 0.021, P = 0.022, P = 0.002, P = 0.018). On multivariate analysis TNM stage and LVI were predictive of DFS.

Conclusion:

TNM stage and LVI were the most important predictors of short-term disease free survival in this study population, confirming that early detection of BCa at a lower stage has a significant impact on short-term outcomes.

KEYWORDS:

Breast carcinoma; Sri Lanka; prognostic indices; short-term survival

PMID:
30303138
DOI:
10.4103/IJPM.IJPM_321_17
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