BACKGROUND: Cancer patients present with a hypercoagulable state often associated with poor disease prognosis. OBJECTIVES: This study aims to evaluate whether thrombin generation (TG), a global coagulation test, may be a useful tool to improve the identification of patients at high risk of early disease recurrence (ie, E-DR within 2 years) after breast cancer surgery. PATIENTS/ METHODS: A cohort of 522 newly diagnosed patients with surgically resected high-risk breast cancer were enrolled in the ongoing prospective HYPERCAN study. TG potential was measured in plasma samples collected before starting systemic chemotherapy. Significant predictive hemostatic and clinic-pathological parameters were identified in the derivation cohort by Cox regression analysis. A risk prognostic score for E-DR was generated in the derivation and tested in the validation cohort. RESULTS: After a median observation period of 3.4 years, DR occurred in 51 patients, 28 of whom were E-DR. E-DR subjects presented with the highest TG values as compared to both late-DR (from 2 to 5 years) and no relapse subjects (P < .01). Multivariate analysis in the derivation cohort identified TG, mastectomy, triple negative and Luminal B HER2-neg molecular subtypes as significant independent predictors for E-DR, which were utilized to generate a risk assessment score. In the derivation and validation cohorts, E-DR rates were 2.3% and 0% in the low-risk, 10.1% and 6.3% in the intermediate-risk, and 18.2% and 16.7%, in the high-risk categories, respectively. CONCLUSIONS: Inclusion of TG in a risk-assessment model for E-DR significantly helps the identification of operated breast cancer patients at high risk of very early relapse.
BACKGROUND:Cancerpatients present with a hypercoagulable state often associated with poor disease prognosis. OBJECTIVES: This study aims to evaluate whether thrombin generation (TG), a global coagulation test, may be a useful tool to improve the identification of patients at high risk of early disease recurrence (ie, E-DR within 2 years) after breast cancer surgery. PATIENTS/ METHODS: A cohort of 522 newly diagnosed patients with surgically resected high-risk breast cancer were enrolled in the ongoing prospective HYPERCAN study. TG potential was measured in plasma samples collected before starting systemic chemotherapy. Significant predictive hemostatic and clinic-pathological parameters were identified in the derivation cohort by Cox regression analysis. A risk prognostic score for E-DR was generated in the derivation and tested in the validation cohort. RESULTS: After a median observation period of 3.4 years, DR occurred in 51 patients, 28 of whom were E-DR. E-DR subjects presented with the highest TG values as compared to both late-DR (from 2 to 5 years) and no relapse subjects (P < .01). Multivariate analysis in the derivation cohort identified TG, mastectomy, triple negative and Luminal B HER2-neg molecular subtypes as significant independent predictors for E-DR, which were utilized to generate a risk assessment score. In the derivation and validation cohorts, E-DR rates were 2.3% and 0% in the low-risk, 10.1% and 6.3% in the intermediate-risk, and 18.2% and 16.7%, in the high-risk categories, respectively. CONCLUSIONS: Inclusion of TG in a risk-assessment model for E-DR significantly helps the identification of operated breast cancerpatients at high risk of very early relapse.
Authors: Marina Marchetti; Patricia Gomez-Rosas; Laura Russo; Sara Gamba; Eleonora Sanga; Cristina Verzeroli; Chiara Ambaglio; Francesca Schieppati; Francesco Restuccia; Ezio Bonanomi; Marco Rizzi; Stefano Fagiuoli; Andrea D'Alessio; Grigorios T Gerotziafas; Luca Lorini; Anna Falanga Journal: Front Cardiovasc Med Date: 2022-06-10
Authors: Patricia Gomez-Rosas; Marina Pesenti; Cristina Verzeroli; Cinzia Giaccherini; Laura Russo; Roberta Sarmiento; Giovanna Masci; Luigi Celio; Mauro Minelli; Sara Gamba; Carmen Julia Tartari; Carlo Tondini; Francesco Giuliani; Fausto Petrelli; Andrea D'Alessio; Giampietro Gasparini; Roberto Labianca; Armando Santoro; Filippo De Braud; Marina Marchetti; Anna Falanga Journal: TH Open Date: 2021-02-10
Authors: Nikolaus B Binder; François Depasse; Julia Mueller; Thomas Wissel; Stephan Schwers; Matthias Germer; Björn Hermes; Peter L Turecek Journal: J Thromb Haemost Date: 2021-10-08 Impact factor: 16.036