Cancer Res Treat.  2015 Jan;47(1):55-63. 10.4143/crt.2013.165.

Ovarian Ablation Using Goserelin Improves Survival of Premenopausal Patients with Stage II/III Hormone Receptor-Positive Breast Cancer without Chemotherapy-Induced Amenorrhea

• Zhou J
• Wu SG
• Wang JJ
• Sun JY
• Li FY
• Lin Q
• Lin HX
• He ZY

• KMID: 2380390
• DOI: http://doi.org/10.4143/crt.2013.165

Abstract

PURPOSE
The purpose of this study was to assess the value of ovarian ablation using goserelin in premenopausal patients with stage II/III hormone receptor-positive breast cancer without chemotherapy-induced amenorrhea (CIA).
MATERIALS AND METHODS
We retrospectively reviewed the data of breast patients treated between October 1999 and November 2007 without CIA. The Kaplan-Meier method was used for calculation of the survival rate. Log rank method and Cox regression analysis were used for univariate and multivariate prognostic analysis.
RESULTS
The median follow-up period was 61 months. Initially, 353 patients remained without CIA after chemotherapy and 98 among those who received goserelin and tamoxifen (TAM). In univariate analysis, goserelin improved locoregional recurrence-free survival (LRFS) (98.9% vs. 94.1%, p=0.041), distant metastasis-free survival (DMFS) (85.4% vs. 71.9%, p=0.006), disease-free survival (DFS) (85.4% vs. 71.6%, p=0.005), and overall survival (OS) (93.5% vs. 83.5%, p=0.010). In multivariate analysis, goserelin treatment was an independent factor influencing DMFS (hazard ratio [HR], 1.603; 95% confidence interval [CI], 1.228 to 2.092; p=0.001), DFS (HR, 1.606; 95% CI, 1.231 to 2.096; p=0.001), and OS (HR, 3.311; 95% CI, 1.416 to 7.742; p=0.006). In addition, treatment with goserelin resulted in significantly improved LRFS (p=0.039), DMFS (p=0.043), DFS (p=0.036), and OS (p=0.010) in patients aged < 40 years. In patients aged > or = 40 years, goserelin only improved DMFS (p=0.028) and DFS (p=0.027).
CONCLUSION
Ovarian ablation with goserelin plus TAM resulted in significantly improved therapeutic efficacy in premenopausal patients with stage II/III hormone receptor-positive breast cancer without CIA.

Keyword

Breast neoplasms; Goserelin; Ovarian ablation; Therapy-induced amenorrhea; Premenopause

MeSH Terms

Amenorrhea*
Breast
Breast Neoplasms*
Disease-Free Survival
Drug Therapy
Female
Follow-Up Studies
Goserelin*
Humans
Multivariate Analysis
Premenopause
Retrospective Studies
Survival Rate
Tamoxifen
Goserelin
Tamoxifen

Figure

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  Fig. 1. Influence of goserelin on locoregional recurrencefree survival of all patients.

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  Fig. 2. Influence of goserelin on distant metastasis-free survival of all patients.

• 

  Fig. 3. Influence of goserelin on disease-free survival of all patients.

• 

  Fig. 4. Influence of goserelin on overall survival of all patients.

Reference

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