Prognostic Value Of Progesterone Receptor Research Articles

Prognostic value of progesterone receptor in solid pseudopapillary neoplasm of the pancreas: evaluation of a pooled case series

BackgroundThe role of progesterone receptor (PR) has been reported in a series of pancreatic cysts. However, the relationship between PR and prognosis of solid pseudopapillary neoplasm of the pancreas (SPNP) has not been elucidated so far. The aim of our study was to evaluate the prognostic value of PR in SPNP.MethodsA total of 76 patients with SPNP treated in our institution from January 2012 to December 2017 were included. Demographic parameters, laboratory data, pathologic information and clinical outcomes were analyzed by the use of survival analysis. In addition, a pooled case series was performed to evaluate the results.ResultsThe institutional data included 76 patients (17 male and 59 female) ranging from 8 to 90 years (median, 30 years) in age. Kaplan-Meier survival analysis confirmed negative PR result was significantly associated with poorer disease-free survival (DFS) and disease-specific survival (DSS) (both P < 0.001). In the pooled analysis, a total of 62 studies comprising 214 patients with SPNP were included. After multivariable cox analysis, negative PR result remained an independent prognostic factor for SPNP (DFS HR: 14.50, 95% CI: 1.98–106.05, P = 0.008; DSS HR: 9.15, 95% CI: 1.89–44.17, P = 0.006).ConclusionOur results indicated the role of PR in predicting adverse outcome of patients with SPNP and negative PR result may serve as a potential prognostic factor.

Prognostic Value of the Progesterone Receptor by Subtype in Patients with Estrogen Receptor-Positive, HER-2 Negative Breast Cancer.

In estrogen receptor-positive (ER+), human epidermal growth factor receptor 2 (HER-2) negative breast cancers, the progesterone receptor (PR) is an independent prognostic marker. Little is known about the prognostic value of PR by tumor grade. We assessed this in two independent datasets. Women with primary operable, invasive ER+ HER-2 negative breast cancer diagnosed between 2000 and 2012, treated at University Hospitals Leuven, were included. We assessed the association of PR status and subtype (grade 1-2 vs. grade 3) with distant recurrence-free interval (DRFI) and breast cancer-specific survival. The interaction between PR status and subtype was investigated, and associations of PR status by subtype were calculated. The BIG 1-98 data set was used for validation. In total, 4,228 patients from Leuven and 5,419 from BIG 1-98 were analyzed. In the Leuven cohort, the adjusted hazard ratio (HR) of PR-positive versus PR-negative tumors for DRFI was 0.66 (95% confidence interval [CI], 0.50-0.89). For the interaction with subtype (p = .34), the HR of PR status was 0.79 (95% CI, 0.61-1.01) in luminal A-like and 0.59 (95% CI, 0.46-0.76) in luminal B-like tumors. In luminal A-like tumors, observed 5-year cumulative incidences of distant recurrence were 4.1% for PR-negative and 2.8% for PR-positive tumors, and in luminal B-like 18.7% and 9.2%, respectively. In the BIG 1-98 cohort, similar results were observed; for the interaction with subtype (p = .12), the adjusted HR of PR status for DRFI was 0.88 (95% CI, 0.57-1.35) in luminal A-like and 0.58 (95% CI, 0.43-0.77) in luminal B-like tumors. Observed 5-year cumulative incidences were similar. PR positivity may be more protective against metastatic relapse in luminal B-like versus luminal A-like breast cancer, but no strong conclusions can be made. In absolute risk, results suggest an absent PR is clinically more important in high compared with low proliferative ER+ HER-2 negative tumors. An absent progesterone receptor (PR) predicts a worse outcome in women treated for an estrogen receptor-positive, human epidermal growth factor receptor 2 negative breast cancer. As low proliferative tumors lacking PR are now also classified high risk, the prognostic value of PR across risk groups was studied. Despite a negative test for interaction of the prognostic value of PR by tumor grade, the magnitude of an absent PR on breast cancer relapse is much larger in high than in low proliferative breast cancers.

Prognostic Impact of Progesterone Receptor Status in Chinese Estrogen Receptor Positive Invasive Breast Cancer Patients.

PurposeEstrogen receptor (ER) and progesterone receptor (PR) have been used as indicators of endocrine system status since the mid-1970s in the clinical management of breast cancer. The predictive role of ER in endocrine therapy is undisputed, but the prognostic value of PR is still debated. The aim of this study was to investigate the clinical characteristics and prognosis of ER positive breast cancer with different PR expression levels.MethodsA population cohort of 3,030 primary invasive ER positive breast cancer patients from a single cancer center underwent surgery and received adjuvant endocrine therapy from 2004 to 2010. The clinical and biological features of these patients with high PR-expressing tumors were compared with those of patients with low PR-expressing tumors. The follow-up data for disease-free survival (DFS), overall survival (OS), and breast cancer specific survival (BCSS) was obtained from 2,778 patients. Cox regression analysis was used to correlate biomarkers and tumor characteristics with DFS, OS, and BCSS.ResultsTumors with low PR expression had more invasive pathological features and biological indexes than those with high PR expression. Low PR expression was an independent poor prognostic factor for DFS (p=0.014; hazard ratio [HR], 0.781; 95% confidence interval [CI], 0.641–0.950), OS (p=0.002; HR, 0.699; 95% CI, 0.560–0.873), and BCSS (p=0.005; HR, 0.714; 95% CI, 0.566–0.902). Furthermore, in low PR expressing tumors, patients who received chemotherapy had better DFS (p=0.002; HR, 0.449; 95% CI, 0.268–0.751), OS (p<0.001; HR, 0.341; 95% CI, 0.192–0.606), and BCSS (p<0.001; HR, 0.292; 95% CI, 0.156–0.549) than patients who did not received chemotherapy.ConclusionPatients with ER positive invasive breast cancer with low PR expressing tumors have a worse prognosis than those with high PR expressing tumors, and these patients can benefit from chemotherapy.

Prognostic impact of progesterone receptor status in 3030 Chinese estrogen receptor positive early breast cancer patients.

e12002Background: Estrogen receptor (ER) and progesterone receptor (PR) have been used as indicators of endocrine system since the mid-1970s in the breast cancer. The predictive role of ER in endocrine therapy is undisputed, but the prognostic value of PR is still debated.The objective of this study was to investigate the clinical characteristics and prognosis of ER+ early breast cancer in different PR expression. Methods: A population cohort of 3030 ER+ primary invasive breast cancer with curative intent patients presenting to a single Cancer Centre over 6 years (2004–2010) underwent surgery and received adjuvant endocrine therapy. Age, menopausal status, tumor size, histology, lymph node status, PR status, Her-2, and Ki-67 were collected. The follow-up data for disease-free survival (DFS) and overall survival (OS) was obtained and distribution of factors was compared using the standard Chi-Square test. Univariate Cox hazard models were used to assess the effects of treatment and predictive factors on cl...

Progesterone receptor loss identifies hormone receptor-positive and HER2-negative breast cancer subgroups at higher risk of relapse: a retrospective cohort study.

BackgroundTo assess the prognostic value of progesterone receptor (PR) expression in patients with hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer subgroups.MethodsA retrospective review of breast cancer patients who underwent mastectomy or breast-conserving surgery between January 1998 and December 2007 was performed. The prognostic impact of PR status on disease-free survival (DFS) was analyzed.ResultsOf the 1,301 patients included in this study, the median follow-up time was 64 months, and the median age was 46 years. There were 18.4% of patients (n=219) with PR negative (PR−) cancer. Women with PR–breast cancer were more likely to be postmenopausal (P<0.001) and have pN3 stage (P=0.031) and Stage III (P=0.049) cancer. Cox regression univariate and multivariate analysis showed that PR status was a significant prognostic factor for DFS. Patients with PR− status had poorer DFS (hazard ratio =1.626, 95% confidence interval =1.060–2.497, P=0.026). The 5-year DFS for patients with PR− and PR+ breast cancer was 79.4% and 86.2%, respectively, and the 8-year DFS for patients with PR− and PR+ breast cancer was 69.6% and 78.1%, respectively (P=0.012). A significant difference in DFS was observed between PR− and PR+ disease in patients with node-negative cancer, but was not for patients with lymph node metastasis (P=0.242). In premenopausal patients, DFS varied significantly by PR status (P=0.049). A marginally significant difference in DFS between the PR− and PR+ disease was seen in postmenopausal patients (log rank P=0.065).ConclusionLack of PR expression is associated with worse survival in patients with hormone receptor-positive and HER2-negative breast cancer subgroups.

Abstract P3-07-10: The association between the expression of progesterone receptor and clinical benefit of adjuvant trastuzumab in estrogen receptor-positive and HER2-positive breast cancer patients

Abstract Background: Previous studies have shown that progesterone receptor (PR) status has a prognostic value in hormone receptor-positive breast cancer. In this study, we evaluated the clinical significance of PR status in estrogen receptor (ER)-positive and HER2-positive breast cancer. Methods: We retrospectively analyzed the data of ER+ and HER2+ breast cancer patients who underwent surgery at Gangnam Severance hospital and Severance hospital from 2002 to 2012. We excluded patients who had a history of previous cancer, received neoadjuvant chemotherapy, did not received adjuvant chemotherapy, and had contralateral breast cancer or metastasis at diagnosis. A total of 346 patients were identified. Among them, 155 patients (44.8%) received adjuvant trastuzumab. Results: At a median follow-up of 59 months, median disease-free survival (DFS) and overall survival (OS) were 56 and 59 months, respectively. The DFS and OS showed no difference according to PR status in overall patients. Then, these patients were categorized into two groups: ER+/HER2+/PR+ and ER+/HER2+/PR-. In ER+/HER2+PR+ patient, there was no difference of DFS or OS according to trastuzumab use. In ER+/HER2+/PR- patients, DFS was significantly better in patients who received adjuvant trastuzumab treatment compared to those who did not (p=0.009). We also analyzed influence of PR status on treatment outcome between patients who received adjuvant trastuzumab and those who did not. In patients who received adjuvant trastuzumab, there was no difference of DFS or OS according to PR status. However, in patients who did not receive adjuvant trastuzumab, ER+/HER2+/PR- patients showed worse DFS than ER+/HER2+/PR+ patients (p=0.006). Conclusions: In patients with ER+/HER2+ breast cancer, we found that a prognostic value of PR only retained in those who did not receive adjuvant trastuzumab. Our findings suggest that the use of adjuvant trastuzumab may offer less clinical benefit for the patients with ER+/HER2+/PR+ breast cancer. Citation Format: Lee HW, Ahn SG, Park JT, Yang BS, Park S, Jeong J, Kim SI. The association between the expression of progesterone receptor and clinical benefit of adjuvant trastuzumab in estrogen receptor-positive and HER2-positive breast cancer patients. [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 P3-07-10.

Prognostic value of progesterone receptor after long-term follow-up in primary breast cancer

In a previous study of a series of 105 patients with primary breast cancer we found that the progesterone receptor (PgR) status was an important prognostic factor for early recurrences. 95 patients from the same series were followed-up for a median of 9.5 years and reassessed for the prognostic value of PgR status by univariate and multivariate statistical methods. In univariate analysis, the disease-free interval was only related to the lymphnode status. For overall survival, PgR and combined PgR-ER (oestradiol receptor) status had a prognostic value ( P = 0.035 and 0.05, respectively). Moreover, PgR status was found to be discriminant for the survival of the node-negative patients ( P = 0.017). In multivariate analysis, ER and PgR status were not significant, indicating that receptor status is not a powerful predictor of the course of breast cancer.

Progesterone receptors and human breast cancer.

Estrogen receptor protein is known to be an important prognostic factor for patients with breast cancer. The presence of estrogen receptor correlates with response to endocrine therapy in patients with metastatic disease and is associated with prolonged disease-free and overall survival in patients with primary disease. But the correlation between estrogen receptor positivity and endocrine dependence is not perfect. Approximately 40% of estrogen receptor positive tumors fail to regress with endocrine therapy. It has been hypothesized that another protein, progesterone receptor, may be a more effective marker of endocrine responsiveness since progesterone receptor is the end product of estrogen action. We have examined the relationship between progesterone receptor and response of advanced breast cancer tumors to hormonal manipulations. Promising retrospective results indicate the need for new, prospective clinical trials to further define the prognostic value of progesterone receptor for these tumors. We have also analyzed the disease-free intervals of patients with primary disease and found that progesterone receptor was more important than estrogen receptor for predicting time to recurrence. We suggest that both estrogen receptor and progesterone receptor be routinely measured in all breast cancer tumors, and that the results of these assays will help the physician individualize therapy for breast cancer patients.