Prognostic Factor For Distant Metastasis-free Survival Research Articles

Outcome of Adenoid Cystic Carcinoma of Head and Neck After Postoperative Intensity Modulation Radiotherapy: A Single Institution Study.

ObjectiveThis study was retrospectively evaluated the outcome of postoperative intensity modulation radiotherapy (IMRT) for patients with adenoid cystic carcinoma of head and neck (ACCHN), and identified the unfavorable prognostic factors.MethodsFifty-five ACCHN patients treated in Sichuan Cancer Hospital between January 2007 and December 2016 were retrospectively evaluated. Median age of patient was 47 years (range, 21–73 years). Thirty-five patients were male and 20 were female. In 30 patients, tumors were located in major salivary glands (54.5%), and 25 patients in minor salivary glands (45.5%). The numbers of R0, R1, and R2 surgical resection classification patients were 22 (40.0%), 20 (36.4%), and 13 (23.6%). The median total RT dose was 62 Gy (range, 46–72 Gy), and 54.5% of patients were treated with adjuvant chemotherapy. Statistical analyses were performed using the Log rank test for univariate analysis and the Cox proportional hazard model for multivariate analysis.ResultsMedian follow-up period was 68.5 months (12–132 months). The 5-year local-regional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS) were 93.9%, 75.3% and 82.5%. In univariate analysis, T stages (p=0.025) and AJCC stages (p=0.036) were the prognostic factors for OS; Age (p=0.042), T stages (p=0.025), N stages (p=0.021), AJCC stages (p=0.021) and adjuvant chemotherapy (p=0.010) were the prognostic factors for DMFS; T stage (p=0.049) was the prognostic factor for LRRFS. In multivariate factors analyses, T stages (p=0.026), AJCC stages (p=0.028) and RT dose (p=0.025) were the significant prognosticators for OS. The most common acute toxicities over three degrees were myelosuppression (5.5%), mucositis (9.1%) and dermatitis (1.8%).ConclusionPostoperative IMRT seems to achieve reasonable local-regional control and OS in patients with adenoid cystic carcinoma of head and neck, with acceptable treatment relative toxicities.

Prognostic value of lymph node to primary tumor standardized uptake value ratio in unresectable esophageal cancer

BackgroundUnresectable esophageal cancer harbors high mortality despite chemoradiotherapy. Better patient selection for more personalized management may result in better treatment outcomes. We presume the ratio of maximum standardized uptake value (SUV) of metastatic lymph nodes to primary tumor (NTR) in 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) may provide prognostic information and further stratification of these patients.MethodsThe patients with non-metastatic and unresectable esophageal squamous cell carcinoma (SCC) receiving FDG PET/CT staging and treated by chemoradiotherapy were retrospectively reviewed. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-off value for NTR. Kaplan-Meier method and Cox regression model were used for survival analyses and multivariable analyses, respectively.ResultsFrom 2010 to 2016, 96 eligible patients were analyzed. The median follow-up time was 10.2 months (range 1.6 to 83.6 months). Using ROC analysis, the best NTR cut-off value was 0.46 for prediction of distant metastasis. The median distant metastasis-free survival (DMFS) was significantly lower in the high-NTR group (9.5 vs. 22.2 months, p = 0.002) and median overall survival (OS) (9.5 vs. 11.6 months, p = 0.013) was also significantly worse. Multivariable analysis revealed that NTR was an independent prognostic factor for DMFS (hazard ratio [HR] 1.81, p = 0.023) and OS (HR 1.77, p = 0.014).ConclusionsHigh pretreatment NTR predicts worse treatment outcomes and could be an easy-to-use and helpful prognostic factor to provide more personalized treatment for patients with non-metastatic and unresectable esophageal SCC.

Shorter Half-Life Clearance of Plasma EBV DNA Is a Significant Prognostic Factor of Non-Metastatic Nasopharyngeal Carcinoma Treated with Radical Intensity-Modulated Radiation Therapy

Plasma Epstein-Barr virus (EBV) DNA has been adopted widely in diagnosis, treatment monitoring and post-treatment surveillance of nasopharyngeal carcinoma (NPC). However, the prognostic role of its plasma clearance in the modern era when intensity-modulated radiotherapy (IMRT) and the 8th edition of AJCC/UICC TNM Staging Classification are fully implemented. We investigated if the half-life clearance of plasma EBV DNA could be an early prognosticator of survival during radical IMRT with or without chemotherapy for previously untreated non-metastatic NPC. Forty-four patients with previously untreated non-metastatic NPC were prospectively recruited and treated with radical IMRT and concurrent chemotherapy +/- induction/adjuvant chemotherapy from 2014 to 2018. All had their plasma EBV DNA measured immediately before treatment followed by weekly schedules until it was undetectable in two consecutive measurements (i.e. 0 copies/ml), as determined by real-time quantitative polymerase chain reaction. Cox regression models were employed to identify prognostic factors of survival. The overall stage distribution was: stage II in 9 (20.4%); stage III in 21 (47.7%) and stage IVA in 14 (31.8%) patients. After a median follow-up of 18.4 months (range 3.4–57.1 months), 2 patients (4.5%), 1 (2.3%) and 4 (9.1%) experienced local recurrences, regional recurrence and distant metastases respectively. Four patients (9.1%) died and all were related to NPC progression. The mean half-life of plasma EBV DNA clearance was 9.82 days. Patients were dichotomized according to the half-life clearance: those with half-life of >15 days had a significantly worse 2-year progression-free survival (PFS) (84.2% vs. 60.0%; p=0.001) and distant metastasis-free survival (DMFS) (94.7% vs. 60.0%; p<0.001) when compared to those with a shorter half-life. Univariable and multivariable analyses demonstrated that age (HR 1.10; 95% CI 1.01–1.19; p=0.026) and half-life (>15 days) were prognostic of PFS (HR 11.13; 95% CI, 2.13–58.11; p=0.007), while half-time (>15 days) was the only prognostic factor of DMFS (HR 14.24; 95% CI, 2.53–79.80; p=0.003). The half-life clearance of plasma EBV DNA was a significant prognostic factor in patients with non-metastatic NPC treated in the modern era. Earlier active surveillance with this relatively non-invasive plasma monitoring tool should be adopted, leading to more prompt subsequent imaging and intensified treatment especially for those who have a suboptimal clearance during their radical treatment.

Analysis of definitive chemo-radiotherapy for esophageal cancer with supra-clavicular node metastasis based on CT in a single institutional retrospective study: a propensity score matching analysis

BackgroundThe prognostic value of supra-clavicular lymph node (SCLN) metastases in esophageal cancer (EC) is still not clear.MethodFrom January 2009 to December 2015, a survival analysis was performed to retrospectively identify the prognostic value of SCLN metastasis on survival on 751 patients with EC treated with definitive chemo-radiotherapy (dCRT).ResultsThe median follow-up duration for living patients was 56.6 months. The median overall survival (OS) for all patients was 16.6 months. Patients with SCLN metastasis had a much poorer prognosis for OS (χ2 = 17.342, P < 0.001), distant metastasis-free survival (DMFS) (χ2 = 24.793, P < 0.001) and progression-free survival (PFS) (χ2 = 25.802, P < 0.001) than those without SCLN metastasis. The same results were found after propensity score matching. Nonetheless, the prognosis of patients with cervical or upper thoracic EC metastasis in SCLN was better than those of patients with middle or lower thoracic EC metastasis in SCLN for OS (χ2 = 4.516, P = 0.038), DMFS (χ2 = 8.326, P = 0.004) and PFS (χ2 = 6.255, P = 0.012). Univariate analysis showed that gender, middle or lower thoracic EC with SCLN metastasis, tumor length, tumor diameter, concurrent chemo-radiotherapy (CCR) and number of lymph nodes were prognostic factors for PFS. Gender, age, middle or lower thoracic EC with SCLN metastasis, tumor diameter, tumor length, and number of lymph nodes were prognostic factors for DMFS. According to the multivariate analysis, only middle or lower thoracic EC with SCLN metastasis and number of lymph nodes were independent prognostic factors for DMFS and PFS.ConclusionFor patients with cervical or upper thoracic EC, metastasis in SCLN should be considered to be regional lymph nodes and treated with curative intent if the total number of lymph nodes is limited. However, for patients with middle or lower thoracic EC, metastasis should be considered to be a higher level N stage or M1 stage, and it is thus necessary to provide consolidation chemotherapy after dCRT.

A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands.

Salivary duct carcinoma (SDC) is a subtype of salivary gland cancer with a dismal prognosis and a need for better prognostication and novel treatments. The aim of this national cohort study was to investigate clinical outcome, prognostic factors, androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2) expression. SDC patients diagnosed between 1990 and 2014 were identified by the Nationwide Network and Registry of Histo‐ and Cytopathology in the Netherlands (PALGA). Subsequently, medical records were evaluated and pathological diagnoses reviewed. Data were analyzed for overall survival (OS), disease‐free survival (DFS), distant metastasis‐free survival (DMFS) and prognostic factors. AR was evaluated by immunohistochemistry (IHC), HER2 by IHC and fluorescent in‐situ hybridization. A total of 177 patients were included. The median age was 65 years, 75% were male. At diagnosis, 68% presented with lymph node metastases and 6% with distant metastases. Median OS, DFS and DMFS were 51, 23 and 26 months, respectively. In patients presenting without distant metastases, the absolute number of positive lymph nodes was associated with poor OS and DMFS in a multivariable analysis. AR and HER2 were positive in 161/168 (96%) and 44/153 (29%) tumors, respectively, and were not prognostic factors. SDC has a dismal prognosis with primary lymph node involvement in the majority of patients. The absolute number of lymph node metastases was found to be the only prognostic factor for DMFS and OS. AR expression and—to a lesser extent—HER2 expression hold promise for systemic treatment in the metastatic and eventually adjuvant setting.

Cervical Lymph Node Metastatic Status and Adjuvant Therapy Predict the Prognosis of Salivary Duct Carcinoma

Salivary duct carcinoma (SDC) is an aggressive malignancy that is not yet fully understood. We designed the present retrospective study to investigate the factors affecting the prognosis of SDC and the effects of adjuvant therapies on the clinical outcomes of patients. Patients with SDC treated surgically from 2006 to 2016 were enrolled in the present retrospective cohort study. The demographic data, clinical pathologic characteristics, and follow-up results were recorded. The prognostic indicators of overall survival (OS), locoregional failure-free survival (LRFFS), and distant metastasis-free survival (DMFS) were analyzed using the Kaplan-Meier method and the Cox proportional hazard model. The study sample included 66 patients, most of whom were male (81.8%). The 5-year OS, LRFFS, and DMFS for all patients was 52.5%, 63.9%, and 51.3%, respectively. Univariate analysis showed that stage N2-N3, lymph node involvement of levels IV and V, 8 or more positive lymph nodes, and extranodal extension were all negative prognostic indicators for OS. The only significant indicator on multivariate analysis was the number of positive lymph nodes. Multivariate analysis revealed that extracapsular invasion and no adjuvant radiotherapy were risk factors for LRFFS. In contrast, lesions involving both glands and 8 or more positive lymph nodes were prognostic factors for DMFS. Further subgroup analysis showed that radiotherapy was only useful for patients with locally advanced lesions for local control. Cervical lymph node metastatic status is an important factor in predicting the prognosis of SDC patients. Adjuvant radiotherapy is useful for local control, especially for patients with stage T4 disease but does not benefit OS and DMFS.

Relationship between positive lymph nodes and distant metastasis after intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma

Objective To explore the relationship between positive cervical lymph nodes and distant metastasis after intensity-modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). Methods A retrospective analysis was performed on the clinical data of 474 patients who were newly diagnosed with NPC but no distant metastasis and received IMRT from 2010 to 2012. The survival rates were calculated by the Kaplan-Meier method. The log-rank test was used for comparison of survival rates and univariate prognostic analysis. The multivariate analysis was made by the Cox regression model. Results In the 474 patients, 400 had positive cervical lymph nodes and 122 had residual masses in the neck after IMRT. The four-year distant metastasis, overall survival, disease-free survival, local relapse-free survival, and distant metastasis-free survival (DMFS) rates were 13.71%(65/474), 82.9%, 81.4%, 93.5%, and 86.3%, respectively. The univariate and multivariate analyses showed that treatment approach, lymph node metastases in lower neck Ⅳ/Ⅴb/Ⅴc regions, the greatest diameter of the positive cervical lymph nodes, the diameter of residual lymph nodes, and time to lymph node recession were independent prognostic factors for DMFS (all P<0.05). Conclusions Chemoradiotherapy can reduce the distant metastasis rate after IMRT for NPC. The larger the cervical lymph nodes are, the more likely there are residual masses; the larger the residual cervical lymph nodes are, the higher risk of distant metastasis there is. Large cervical lymph nodes (≥6 cm), residual masses larger than 1 cm, and residual masses at 3 months after IMRT are negative prognostic factors for DMFS after IMRT for NPC. Better intervention treatment approaches need to be explored. Key words: Nasopharyngeal neoplasms/intensity-modulated radiotherapy; Distant metastasis; Lymph node

Abstract P6-10-18: Phyllodes tumor of the breast, clinicopathological features and prognostics factors in a retrospective cohort with 7-year follow-up

Abstract BACKGROUND: The phyllodes tumor of the breast is a rare neoplasm that represent less than 1% of all breast tumors and between 2.5% of fibroepithelial tumors. Often develop local recurrence and more infrequently metastatic capability. OBJECTIVE: The aim of this study was to describe clinical pathological characteristics and identify prognostics factors in terms of local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) and overall survival (OS) in patients with phyllodes tumors of the breast. METHODS: We retrospectively analyzed 157 patients diagnosed and treated at the "Instituto Nacional de Enfermedades Neoplasicas" between January 2005 to December 2010. In order to evaluate the relationship between clinical features and histology of the tumors, the Pearson χ2 test was used. Kaplan-Meier method with Log-rank test or Breslow test (when it was applicable) was used to identify prognostic factors in terms of LRFS, DMFS and OS. RESULTS: The median age was 42 years (range: 13-81 years), 98 (62.4%) cases ≤ 45 years and 59 (37.6%) cases &amp;gt; 45 years; 88 (56.1%) had tumors in the right breast, 67 (42.7%) in the left breast and 2 (1.3%) had bilateral tumor. The mean of tumor size was 6.3 cm (range: 0.7-30 cm). Sixty three (40%) tumors were ≤5 cm and 94 (59.9%) were &amp;gt;5cm. Regarding the histological classification, 100 (63.7%) cases were benign, 35 (22.3%) were borderline and 22 (14%) were malignant. Age (p=0.047), tumor size (p=0.001), atypical stromal (p=0.066), stromal cellularity (p&amp;lt;0.001), pleomorphism (p&amp;lt;0.001) and tumor necrosis (p=0.003) were associated to the histological type. Local recurrence occurred in 9 patients, 2 developed distant recurrence and 1 patient presented synchronously local and metastatic recurrence. In the univariate analysis, histological subtype (p=0.006) and pleomorphism (p&amp;lt;0.001) were identified as prognostic factors of LRFS, while the surgical approach (p=0.008), histological type (p&amp;lt;0.001) and some histological features such as stromal cellularity (P&amp;lt;0.001), pleomorphism (p&amp;lt;0.001), heterologous elements (p&amp;lt;0.001) and tumor necrosis (p=0.004) were identified as prognostic factors for DMFS. In regard to the OS, we found as prognosis factors, histology (p= 0.044), pleomorphism (p&amp;lt;0.001) and tumor necrosis (p=0.001). CONCLUSIONS: In our institution we have a low incidence (2.3%) of Phyllodes tumors of the breast and the majority of our patients were benign tumors and had good prognosis. We found that histological type and degree of pleomorphism are prognostic factors at LRFS and OS. Surgical approach, histological type and some histological characteristics were predictors for DMFS. Keywords: Phyllodes tumor, local recurrence, distant recurrence, overall survival. Citation Format: Morante Z, Araujo J, Fuentes H, Neciosup S, Gomez H. Phyllodes tumor of the breast, clinicopathological features and prognostics factors in a retrospective cohort with 7-year follow-up. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-10-18.

Involvement of both Cervical Lymph Nodes and Retropharyngeal Lymph Nodes has prognostic value for N1 patients with Nasopharyngeal Carcinoma

BackgroundThe N1 definition of 2010 UICC/AJCC staging system for nasopharyngeal carcinoma (NPC) covers quite a large range of nodal pattern. The objective of this research is to investigate prognostic value of lymph nodes related factors including involvement of both cervical lymph nodes (CLNs) and retropharyngeal lymph nodes (RLNs) or not, size and number of cervical lymph nodes (CLNs) in N1 patients with NPC.Methods142 newly diagnosed non-metastatic N1 patients with NPC, staged according to the 2010 AJCC staging system for NPC were retrospectively enrolled. All patients had undergone contrast-enhanced magnetic resonance imaging (MRI), and received radiotherapy, with or without chemotherapy as their primary treatment.ResultsThe median follow-up was 48 months. The 5-year local recurrence-free survival (LFS), nodal recurrence-free survival (NFS), local-regional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) of the whole group were 82.3%, 83.0%, 81.0%, 82.1%, 75.3% and 89.8%, respectively. In univariate analysis, patients with both CLNs and RLNs involvement showed a significant lower DMFS, PFS and LRFS than the rest patients (p = 0.004 p = 0.003 and p = 0.034, respectively). Neither size nor number of CLNs affected the survival. In multivariate analysis, involvement of both CLNs and RLNs was an independent prognostic factor for DMFS and PFS (p = 0.019, p = 0.019), but there was no enough evidence confirming its prognostic value for LRFS (p = 0.051).ConclusionsFor N1 patients with NPC, involvement of both RLNs and CLNs may be a potentially prognostic factor for distant metastasis and disease progression. The N stage for N1 patients with involvement of both cervical lymph nodes and retropharyngeal lymph nodes might need to be deliberated.

Long-term outcome of nasopharyngeal carcinoma treated with reduced-volume intensity-modulated radiotherapy and chemotherapy

Objective To analyze the long-term outcome of nasopharyngeal carcinoma (NPC)patients treated with intensity-modulated radiotherapy (IMRT) with reduced clinical target volume (CTV)and to provide a basis for the application of reduced-volume IMRT in the treatment of NPC.Methods Between November 2003 and April 2007,413 patients with NPC were treated with IMRT according our institutional protocol.The median age was 45 years;the patients included 311 males and 102 females.Of all patients,3(0.7％) had stage Ⅰ NPC,66(16％) had stage Ⅱ NPC,235(56.9％) had stage Ⅲ NPC,78(18.9％) had stage Ⅳa NPC,and 31 (7.5％) had stage Ⅳb NPC,according to the 6th edition of AJCC staging system.IMRT was delivered as follows:GTV 66.00-69.75 Gy/30-33 f; CTV-1 60.00-66.65Gy/30-33 f; CTV-2/CTV-N 54.0-55.8 Gy/30-33 f.A total of 336 patients received cisplatin-based chemotherapy in addition to IMRT.Results The follow-up rate was 100％.With a median follow-up of 72months,the 5-year overall survival (OS),local control,loco-regional recurrence-free survival,distant metastasis-free survival (DMFS),and disease-free survival rates were 80％,93％,96％,81％,and 75％,respectively.The multivariate analysis revealed that T stage,N stage,and age were independent prognostic factors for OS (P =0.001,0.001,0.002) ; T stage and N stage were independent prognostic factors for DMFS (P =0.000,0.001).Among patients with stage Ⅲ and Ⅳ NPC,the 5-year OS rate was nonsignificantly higher in those treated with induction chemotherapy than in those not treated with induction chemotherapy (78％ vs.68％,P =0.053),but the 5-year DMFS rate was significantly lower in those treated with adjuvant chemotherapy than in those not treated with adjuvant chemotherapy (65％ vs.83％,P =0.003).Conclusions IMRT with reduced CTV is safe and reliable and can lead to a good long-term outcome in patients with NPC. Key words: Nasopharyngeal neoplasms/intensity-modulated radiotherapy; Nasopharyngeal neoplasms/chemotherapy ; Prognosis

Long-term results of elderly nasopharyngeal carcinoma treated with conventional radiotherapy alone in 95 cases

Objective To evaluate the outcomes and toxicities of elderly nasopharyngeal carcinoma (NPC) treated with conventional radiotherapy alone.Methods From January 1995 to December 1998,95 newly diagnosed nasopharyngeai carcinoma with age ≥65 years treated in our hospital.The clinical data were analyzed retrospectively.Kaplan-Meier method was used for analysis of local-regional control survival and distant metastasis-free survival. The Logrank test was used for univariate prognostic analysis and Cox regression was used for multivariable prognostic analysis.Results The follow-up rate was 98％.The 3-,5- and 8-year local-regional control (LRC) and distant metastasis-free survival (DMFS) rates were 89％,87％,84％ and 85％,79％,79％,respectively. The most common acute toxicities were grade1-2 leukopenia (36％),skin reaction (64％) and mucositis (66％).The most frequent late toxicities were hearing impairment (8％),trismus ( 10％ ) and radiation-induced cranial neuropathy (5％).In univariate analysis,interruption of radiotherapy ( χ2 =7.45,P =0.006 ) and regional neck lymph nodes response (χ2 =4.17,P=0.041 ) was the prognostic factors for LRC,T stage (χ2 =4.16,P=0.032),N stage ( χ2 =4.66,P =0.031 ) and interruption of radiotherapy ( χ2 =9.42,P =0.002 ) was the prognostic factors for DMFS. In multivariable analysis,interruption of radiotherapy and the regional neck lymph nodes response were the prognostic factors for LRC (χ2=6.19,P=0.013 and χ2=12.16,P=0.002;respectively),N stage and radiotherapy interruption were prognostic factors for DMFS.(χ2=15.06,P =0.000 and χ2 =21.62,P =0.000 ; respectively ).Conclusions Conventional radiotherapy alone for elder NPC can produce satisfactory results with acceptable treatment-relative toxicities.Our experience showed that the early N stage,without radiotherapy interruption and good regional lymph nodes response had a good longterm prognosis. Key words: Nasopharyngeal neoplasms, elderly/radiotherapy; Radiotherapy, conventional; Prognosis

Ki-67 gives additional prognostic information on St Gallen 2007 and Adjuvant! Online risk categories in early breast cancer.

Abstract Abstract #1086 Purpose: We sought to determine the significance of Ki-67, one of the tumor cell proliferation indexes, as a useful prognostic factor in early breast cancer.&amp;#x2028; Patients and Methods: 1,080 consecutive patients with stage I or II breast cancer operated between 1998 and 2003 were enrolled. Patients were categorized based on the 2007 St. Gallen consensus and Adjuvant! Online. The expression of Ki-67 in the tumor was assayed using immunohistochemistry (cut-off value: 10%).&amp;#x2028; Results: Univariate analysis revealed that tumor size, lymph node involvement, histologic grade, estrogen receptor, progesterone receptor, bcl-2, and Ki-67 (≥10%) were significant for both overall survival (OS) and distant metastasis-free survival (DFS). Of them, lymph node involvement and high Ki-67 expression were identified as independent prognostic factors for OS at multivariate analysis. The survivals of intermediate- and high-risk groups according to 2007 St Gallen consensus were further separated by Ki-67 expression level (5-yr DFS rate=93.3% vs 86.6% for Ki-67&amp;lt;10% and ≥10%, respectively in intermediate-risk group (p=.001); 5-yr DFS rate=83.1% vs 61.5% for Ki-67&amp;lt;10% and ≥10%, respectively in high-risk group (p=.006)). The survivals of low- and high-risk groups according to Adjuvant! Online were further separated by Ki-67 expression level [5-yr DFS rate=97.8% vs 89.5% for Ki-67&amp;lt;10% and ≥10%, respectively in low-risk group (p=.010); 5-yr DFS rate=90.4% vs 82.6% for Ki-67&amp;lt;10% and ≥10% in high-risk group (p=.005)).&amp;#x2028; Conclusion: Ki-67 was an independent prognostic factor for DFS and OS in early breast cancer, and could give additional prognostic information on the risk grouping by 2007 St Gallen consensus and Adjuvant! Online. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1086.