RESUMO
The relationship between the systemic inflammatory response (as evidenced by elevated C-reactive protein and lowered albumin concentrations), clinico-pathologic status and relapse-free, cancer-specific and overall survival was examined in patients with invasive primary operable breast cancer (n=300). The median follow-up of the survivors was 46 months. During this period, 37 patients relapsed and 25 died of their cancer. On multivariate analysis, only tumour size (P<0.05), albumin (P<0.01) and systemic treatment (P<0.0001) were significant independent predictors of relapse-free, cancer-specific and overall survival. Lower serum albumin concentrations (Assuntos
Neoplasias da Mama/patologia
, Neoplasias da Mama/cirurgia
, Adulto
, Neoplasias da Mama/sangue
, Proteína C-Reativa/metabolismo
, Carcinoma Ductal/patologia
, Carcinoma Ductal/cirurgia
, Intervalo Livre de Doença
, Feminino
, Humanos
, Inflamação/sangue
, Inflamação/patologia
, Contagem de Leucócitos
, Pessoa de Meia-Idade
, Estadiamento de Neoplasias
, Albumina Sérica/metabolismo
, Taxa de Sobrevida
RESUMO
Prediction of outcome in patients with metastatic breast cancer remains problematical. The present study evaluated the value of an inflammation-based score (Glasgow Prognostic Score, GPS) in patients with metastatic breast cancer. The GPS was constructed as follows: patients with both an elevated C-reactive protein (>10 mg l(-1)) and hypoalbuminaemia (<35 g l(-1)) were allocated a score of 2. Patients in whom only one or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively. In total, 96 patients were studied. During follow-up 51 patients died of their cancer. On multivariate analysis of the GPS and treatment received, only the GPS (HR 2.26, 95% CI 1.45-3.52, P<0.001) remained significantly associated with cancer-specific survival. The presence of a systemic inflammatory response (the GPS) appears to be a useful indicator of poor outcome independent of treatment in patients with metastatic breast cancer.
Assuntos
Neoplasias da Mama/patologia , Escala de Resultado de Glasgow , Inflamação/patologia , Metástase Neoplásica/patologia , Neoplasias da Mama/mortalidade , Proteína C-Reativa/análise , Intervalo Livre de Doença , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Albumina Sérica , Análise de Sobrevida , Taxa de SobrevidaRESUMO
The extent of deprivation (Carstairs deprivation index) was directly associated with the magnitude of the systemic inflammatory response (reduced albumin and elevated C-reactive protein, P<0.01) in patients with primary operable breast cancer (n=314). Deprivation was not associated with age, tumour size, tumour type, grade, and the proportion of patients with involved lymph nodes and oestrogen receptor status.