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. 2014 Oct;18(5):266-70.
doi: 10.1016/j.anndiagpath.2014.07.001. Epub 2014 Jul 17.

Residual Tumor Thickness at the Tumor-Normal Tissue Interface Predicts the Recurrence-Free Survival in Patients With Liver Metastasis of Breast Cancer

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Free PMC article

Residual Tumor Thickness at the Tumor-Normal Tissue Interface Predicts the Recurrence-Free Survival in Patients With Liver Metastasis of Breast Cancer

Jane H Zhou et al. Ann Diagn Pathol. .
Free PMC article

Abstract

Tumor response to neoadjuvant therapy is a significant predictive indicator of recurrence-free survival. We measured tumor response using residual tumor thickness at the tumor-normal tissue interface (TNI) and evaluated its association with outcome in patients with liver metastasis of breast cancer. We included 48 patients who underwent neoadjuvant therapy followed by partial liver resection at MD Anderson Cancer Center between 1997 and 2010. The hematoxylin-eosin-stained tumor sections were evaluated for both pathologic response and the residual tumor thickness at the TNI by 3 pathologists who were blinded to the clinical information, treatment regimen, and patient outcome. The residual tumor thickness at the TNI was correlated with recurrence-free survival using Kaplan-Meier method and log-rank test. Cox proportional hazard model was used to identify predictors of recurrence-free survival. All patients were women with a median age of 43 years. The median duration of follow-up was 52.1 months. Residual tumor thickness less than or equal to 3 mm at the TNI correlated with major pathologic response and was associated with longer recurrence-free survival in both univariate and multivariate analyses. Residual tumor thickness at the TNI predicts recurrence-free survival and provides an objective outcome end point in patients who underwent neoadjuvant therapy and liver resection of metastatic breast cancer. We suggest using both the pathologic response and the residual tumor thickness at the TNI to measure tumor response to therapy to improve accuracy.

Keywords: Liver metastasis of breast cancer; Pathologic predictive marker; Pathologic response.

Figures

Figure 1
Figure 1
Hematoxylin-eosin–stained sections (4X and 10X) show major (A and B) and minor (C and D) pathologic response to neoadjuvant chemotherapy for liver metastasis from breast cancer.
Figure 2
Figure 2
Hematoxylin-eosin–stained section (10X) demonstrates the method of measuring tumor thickness at the tumor-normal interface. The yellow dotted line indicates the tumor-normal interface.
Figure 3
Figure 3
A. Scatter plot correlating the residual tumor cells with tumor thickness at the tumor-normal interface. The solid line indicates the regression line, and the dotted line indicates the 95% confidence interval. B. Receiver operating curve demonstrating the cutoff value to differentiate a major from a minor pathologic response.
Figure 4
Figure 4
Kaplan-Meier curves demonstrate the recurrence-free survival in association with A. pathologic response, and B. the residual tumor thickness at tumor-normal interface.

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