Clinical Model For Np Regimen As Postoperative Adjuvant Chemotherapyï½—ith Completely Resected Breast Cancer

OBJECTIVE:The purpose of this study was to investigate the prognostic factors of 132 patients accepted NP regimen as postoperative adjuvant chemotherapy with breast cancer and establish a reliable model of clinical index for exploring the individual treatment mode by analyzing factors including age, KPS, tumor size, Pathological types, TNM staging system, lymph node status, cycles of chemotherapy, adverse effects, estrogen receptor, progesterone receptor, the changes of serum levels of Carcinoembryonicantigen (CEA) and Carbohydrate antigen153 (CA153).METHODS: A retrospective analysis was performed on 132 cases of postoperative breast cancer from September 1994 to January 2007. Survival rate of the 132 patients with NP regimen as postoperative adjuvant chemotherapy of breast cancer was observed, all the diagnosis of the patients were established by histology or cytology and staged by related exams, and prognostic factors were analyzed by using SPSS 12. Kaplan-Meier and Cox regression were used to analyze the relationship between the prognostic factors and survival time in the 132 cases of postoperative breast cancer. Survival curves were plotted according to the Kaplan-Meier method. A clinical model was established according to Cox regression.RESULTS:Kaplan-Meier analysis showed that following factors were related to the prognosis (P<0.05), including tumor size, TNM staging system, lymph node status, operation mode,. Multivariate analysis by Cox proportional hazards model indicated that TNM staging system, lymph node status, operation mode, cycles of chemotherapy, ER, PR, cerb2 and the change of serum levels of CA153-chemotherapy were independent prognostic factors. The six prognostic factors were used to establish a prognostic index (PI) model: PI=0.818 TNM stage - 0.852 lymph node status - 1.107 operation mode - 1.236 cycles of chemotherapy + 1.596 ER - 1.854 PR + 0.994 cerb2 + 1.522 CA153 +β0.CONCLUSIONS:1. TNM staging system, lymph node status , operation mode, cycles of chemotherapy, ER,PR,cerb2 and the changes of serum levels of CA153 are independent and important prognostic factors for NP regimen as Postoperative Adjuvant Chemotherapy with Completely Resected Breast Cancer2. Eight of these prognostic factors are used to establish a prognostic index (PI) model for all 132 cases patients: PI=0.818 TNM stage - 0.852 lymph node status - 1.107 operation mode - 1.236 cycles of chemotherapy + 1.596 ER - 1.854 PR + 0.994 cerb2 + 1.522 CA153 +β0.3. This prognostic index would be helpful in guiding patient management and the design of clinical trials.