Nikiforita Poulakaki1, Georgios-Marios Makris2, Marco-Johannes Battista3, Daniel Böhm4, Kalliopi Petraki5, Dimitrios Bafaloukos5, Theodoros N Sergentanis6, Charalampos Siristatidis7, Charalampos Chrelias7, Nikolaos Papantoniou7. 1. General Hospital "Metropolitan", Athens, Greece. Electronic address: poulakakifiorita@yahoo.com. 2. Third Department of Obstetrics and Gynecology, "Attikon Hospital", National University of Athens, Athens, Greece; Department of Gynecology and Obstetrics, University Hospital Mainz, Mainz, Germany. 3. Department of Gynecology and Obstetrics, University Hospital Mainz, Mainz, Germany. 4. Department of Gynecology, Soeder-Boehm Gynecological Clinic, Mainz, Germany. 5. General Hospital "Metropolitan", Athens, Greece. 6. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National University of Athens, Greece. 7. Third Department of Obstetrics and Gynecology, "Attikon Hospital", National University of Athens, Athens, Greece.
Abstract
PURPOSE: Local recurrence is considered a major concern in patients diagnosed with ductal carcinoma in situ (DCIS), as its invasive occurrence is associated with high rates of distant disease and mortality. This study aims to assess the possible correlation of hormonal receptor status, Ki-67 and HER2 expression with recurrence rates in women with DCIS, taking also into account the potential prognostic effects of grade and age at diagnosis. METHODS: 230 consecutive patients with DCIS were included in this study. Invasive and non-invasive recurrence events were recorded, as a total. Clinicopathological information, as well as PR positivity, ER positivity, HER2 positivity and ki-67 expression were analyzed. Multivariable Cox regression analysis was performed, examining the risk factors for recurrence. RESULTS: Recurrence was noted in 17.8% of cases; the median follow-up was 44 months. Higher grade (adjusted HR = 1.72, 95%CI: 1.06-2.78), age at diagnosis (adjusted HR = 0.60, 95%CI: 0.43-0.83), Ki-67 expression (adjusted HR = 1.78, 95%CI: 1.11-2.88), and type of administered treatment were independently associated with increased recurrence rates. Recurrence rates were not significantly associated with ER, PR status or HER2 expression. CONCLUSION: In addition to high grade, administered treatment and younger age at diagnosis, high Ki-67 expression seems to be independently associated with increased likelihood of recurrence in patients with DCIS. Future studies with additional molecular markers seem necessary to further improve the identification of high-risk patients for DCIS recurrence.
PURPOSE: Local recurrence is considered a major concern in patients diagnosed with ductal carcinoma in situ (DCIS), as its invasive occurrence is associated with high rates of distant disease and mortality. This study aims to assess the possible correlation of hormonal receptor status, Ki-67 and HER2 expression with recurrence rates in women with DCIS, taking also into account the potential prognostic effects of grade and age at diagnosis. METHODS: 230 consecutive patients with DCIS were included in this study. Invasive and non-invasive recurrence events were recorded, as a total. Clinicopathological information, as well as PR positivity, ER positivity, HER2 positivity and ki-67 expression were analyzed. Multivariable Cox regression analysis was performed, examining the risk factors for recurrence. RESULTS: Recurrence was noted in 17.8% of cases; the median follow-up was 44 months. Higher grade (adjusted HR = 1.72, 95%CI: 1.06-2.78), age at diagnosis (adjusted HR = 0.60, 95%CI: 0.43-0.83), Ki-67 expression (adjusted HR = 1.78, 95%CI: 1.11-2.88), and type of administered treatment were independently associated with increased recurrence rates. Recurrence rates were not significantly associated with ER, PR status or HER2 expression. CONCLUSION: In addition to high grade, administered treatment and younger age at diagnosis, high Ki-67 expression seems to be independently associated with increased likelihood of recurrence in patients with DCIS. Future studies with additional molecular markers seem necessary to further improve the identification of high-risk patients for DCIS recurrence.
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