Recurrence dynamics does not depend on the recurrence site Export

@article{citeulike:3390262, abstract = {INTRODUCTION:The dynamics of breast cancer recurrence and death, indicating a bimodal hazard rate pattern, has been confirmed in various databases. To help interpret this finding, a few explanations were suggested, assuming that each peak is generated by clustering of similar recurrences while different peaks result from distinct categories of recurrence.METHODS:The recurrence dynamics in a series of 1526 patients, undergoing conservative surgery at the National Cancer Institute of Milan, for whom the site of first recurrence was recorded, was analyzed. The study was focused on the first clinically relevant event occurring during the follow up (i.e. local recurrence, distant metastasis, contralateral breast cancer, second primary), the dynamics of which was studied by estimating the specific hazard rate. RESULTS:The hazard rate for any recurrence (including both local and distant disease relapses) displayed a bimodal pattern with a first surge peaking at about 24 months and a second peak near to 60 months. The same pattern was observed when the whole recurrence risk was split into the risk of local recurrence and the risk of distant metastasis. However, the hazard rate curves for both cotralateral breast tumours and second primaries revealed uniform course at a nearly constant level. When patients with distant metastases were grouped by site of recurrence (soft tissue, bone, lung or liver or central nervous system), the corresponding hazard rate curves proved to display the typical bimodal pattern with a first peak at about 24 and a later peak at about 60 months.CONCLUSIONS:The bimodal dynamics for early breast cancer recurrence is once again confirmed, providing support to the proposed tumour-dormancy-based model. The recurrence dynamics does not depend on the site of metastasis indicating that the different timing of recurrences is generated by factors influencing the metastatic development regardless of the seeded organ. This finding supports the view that the disease course following primary tumour surgical removal basically follows a common pathway with well defined steps and that the recurrence risk pattern results from inherent features of the metastasis development process, which are apparently attributable to tumour cells.}, author = {Demicheli, Romano and Biganzoli, Elia and Boracchi, Patrizia and Greco, Marco and Retsky, Michael}, citeulike-article-id = {3390262}, citeulike-linkout-0 = {http://dx.doi.org/10.1186/bcr2152}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18844974}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18844974}, doi = {10.1186/bcr2152}, issn = {1465-5411}, journal = {Breast Cancer Research}, keywords = {bimodal, breast, cancer, recurrence}, number = {5}, posted-at = {2008-10-10 16:25:34}, priority = {2}, title = {Recurrence dynamics does not depend on the recurrence site}, url = {http://dx.doi.org/10.1186/bcr2152}, volume = {10}, year = {2008} }

TY - JOUR ID - citeulike:3390262 L3 - citeulike-article-id:3390262 N2 - INTRODUCTION:The dynamics of breast cancer recurrence and death, indicating a bimodal hazard rate pattern, has been confirmed in various databases. To help interpret this finding, a few explanations were suggested, assuming that each peak is generated by clustering of similar recurrences while different peaks result from distinct categories of recurrence.METHODS:The recurrence dynamics in a series of 1526 patients, undergoing conservative surgery at the National Cancer Institute of Milan, for whom the site of first recurrence was recorded, was analyzed. The study was focused on the first clinically relevant event occurring during the follow up (i.e. local recurrence, distant metastasis, contralateral breast cancer, second primary), the dynamics of which was studied by estimating the specific hazard rate. RESULTS:The hazard rate for any recurrence (including both local and distant disease relapses) displayed a bimodal pattern with a first surge peaking at about 24 months and a second peak near to 60 months. The same pattern was observed when the whole recurrence risk was split into the risk of local recurrence and the risk of distant metastasis. However, the hazard rate curves for both cotralateral breast tumours and second primaries revealed uniform course at a nearly constant level. When patients with distant metastases were grouped by site of recurrence (soft tissue, bone, lung or liver or central nervous system), the corresponding hazard rate curves proved to display the typical bimodal pattern with a first peak at about 24 and a later peak at about 60 months.CONCLUSIONS:The bimodal dynamics for early breast cancer recurrence is once again confirmed, providing support to the proposed tumour-dormancy-based model. The recurrence dynamics does not depend on the site of metastasis indicating that the different timing of recurrences is generated by factors influencing the metastatic development regardless of the seeded organ. This finding supports the view that the disease course following primary tumour surgical removal basically follows a common pathway with well defined steps and that the recurrence risk pattern results from inherent features of the metastasis development process, which are apparently attributable to tumour cells. IS - 5 JF - Breast Cancer Research SN - 1465-5411 TI - Recurrence dynamics does not depend on the recurrence site VL - 10 KW - bimodal KW - breast KW - cancer KW - recurrence AU - Demicheli, Romano AU - Biganzoli, Elia AU - Boracchi, Patrizia AU - Greco, Marco AU - Retsky, Michael PY - 2008/// UR - http://dx.doi.org/10.1186/bcr2152 ER -