Publications 2003

Incidence of liver metastases in patients receivig adjuvant chemotherapy after lymph node positive primary colon cancer

Gruenberger T, Schwanzer E, Samonigg H, Hausmaninger H, Jakesz R

Journal of Gastrointestinal Surgery

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Pelvic radiological imaging: a surgeon’s perspective

Herbst F

European Journal of Radiology 2003 Aug;47(2):135-41.

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In reply to: Paradigm shift in adjuvant treatment of receptor positive premenopausal breast cancer patients? Not yet.

Jakesz R

Journal of Clinical Oncology

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Randomised trial: One cycle of anthracycline-containing adjuvant chemotherapy compared with six cycles of CMF treatment in node-positive, hormone receptor negative breast cancer patients

Ploner F, Jakesz R, Hausmaninger H, Kolb R, Stierer M, Fridrik M, Steindorfer P, Gnant M, Haider K, Mlineritsch B, Tschurtschenthaler G, Steger G, Seifert M, Kubista E, Samonigg H

Onkologie 2003 Apr;26(2):115-9.

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Dendritic Cell-Based Vaccination in Solid Cancer

Stift A, Dubsky P, Bachleitner-Hofmann T, Schueller G, Zontsich T, Benkoe T, Radelbauer K, Brostjan C, Jakesz R, Gnant M

Journal of Clinical Oncology 2003 Jan 1;21(1):135-42.


Preventive mastectomy in patients at breast cancer risk due to genetic alterations in the BRCA1 and BRCA2 gene

Taucher S, Gnant M, Jakesz R

Langenbecks Archive of Surgery 2003 Mar;388(1):3-8. Epub 2003 Feb 21.

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Predictive value of p27 KIP1 expression in premenopausal women with early-stage hormone receptor-positive breast cancer

Filipits M, Pohl G, Rudas M, Dietze O, Lax S, Pirker R, Zielinski C, Kubista E, Samonigg H

American Society of Clinical Oncology 2003

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High p27 Kip1 expression predicts superior relapse-free and overall survival for premenopausal women with early-stage breast cancer receiving adjuvant treatment with tamoxifen plus goserelin

Pohl G, Rudas M, Dietze O, Lax S, Markis E, Pirker R, Zielinski C, Hausmaninger H, Kubista E, Samonigg H, Jakesz R, Filiptis M

Journal of Clinical Oncology 2003, 21(19):3594-3600

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Meeting Highlights: Updated International Expert Consensus on the Primary Therapy of Early Breast Cancer

Aron Goldhirsch, William C. Wood, Richard D. Gelber, Alan S. Coates, Beat Thürlimann, and Hans-Jörg Senn

Journal of Clinical Oncology 21:3357-3365, 2003

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Impact of pretreatment thrombocytics on survival in primary breast cancer

Susanne Taucher, Andreas Salat, Michael Gnant, Werner Kwasny, Brigitte Mlineritsch, Rainer-Christian Menzel, Marianne Schmid, Michael G. Smola, Michael Stierer, Christoph Tausch, Arkid Galid, Günther Steger, Raimund Jakesz, for the Austrian Breast and Colorectal Cancer Study Group

Thromb Haemost 2003; 89: 1098-106

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Significant Increase in Breast Conservation in 16 Years of Trials Conducted by the Austrian Breast & Colorectal Cancer Study Group

Raimund Jakesz, MD, Hellmut Samonigg, MD, Michael Gnant, MD, Ernst Kubista, MD, Dieter Depisch, MD, Roland Kolb, MD, Brigitte Mlineritsch, MD, Hans-Jörg Mischinger, MD, Rainer-Christian Menzel, MD,
Peter Steindorfer, MD, Werner Kwasny, MD, Christoph Tausch, MD, Michael Stierer, MD, Susanne Taucher, MD, Michael Seifert, MD, and Hubert Hausmaninger, MD, for the Austrian Breast & Colorectal Cancer Study Group

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Abstract

Objective: To confirm evidence that breast-conserving treatment (BCT) does not impair the prognosis in breast cancer patients as compared to mastectomy and to argue that it be regarded as the treatment of choice in stage I and II disease.

Summary Background Data: Scientifically, survival rates in breast cancer have been shown to be stage-dependent, but independent of the extent of surgical breast tissue removal, as long as the resection margins are free of tumor infiltration.

Methods: Between 1984 and 1997, six different trials conducted by the Austrian Breast & Colorectal Cancer Study Group accrued a total of 4,259 women with hormone-responsive disease. The authors selected and compared three patient groups (n = 3,316) according to pathologic stage, age, and the surgical procedure applied.

Results: Over this interval, the BCT rate in the premenopausal node-positive subgroup experienced a highly significant increase from 27.2% to 73.2% overall. In the group of postmenopausal node-negative patients, the BCT rate grew significantly by 37.3% to 77.3% in total. With an overall BCT rate growing from 22.5% to 56.8% in postmenopausal node-positive women, those presenting with T1 tumors saw a significant increase from 35.1% to 65.9%. Mortality and local recurrence rates proved stable or even decreased considerably over time and in all subgroups.

Conclusions: The presented outcome of BCT rates, significantly improved over this 16-year period and in no way counterbalanced by higher local recurrence or death rates, reflects an excellent example of surgical quality control. BCT can safely be regarded as the standard of therapy for T1 and increasingly for T2 disease. Especially in multi-institutional adjuvant breast cancer trials, the highest priority should be given to breast-conserving procedures.

ANNALS OF SURGERY Vol. 237, No. 4, 556–564, 2003

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Randomized Trial of Tamoxifen Versus Tamoxifen Plus Aminoglutethimide as Adjuvant Treatment in Postmenopausal Breast Cancer Patients With Hormone Receptor-Positive Disease: Austrian Breast and Colorectal Cancer Study Group – Trial 6

Marianne Schmid, Raimund Jakesz, Hellmut Samonigg, Ernst Kubista, Michael Gnant, Christian Menzel, Michael Seifert, Karin Haider, Susanne Taucher, Brigitte Mlineritsch, Peter Steindorfer, Werner Kwasny, Michael Stierer, Christoph Tausch, Michael Fridrik, Viktor Wette, Gu¨nther Steger, and Hubert Hausmaninger

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Abstract

PURPOSE: To determine whether the addition of aminoglutethimide to tamoxifen is able to improve the outcome in postmenopausal patients with hormone receptor-positive, early-stage breast cancer.

PATIENTS AND METHODS: A total of 2,021 postmenopausal women were randomly assigned to receive either tamoxifen for 5 years alone or tamoxifen in combination with aminoglutethimide (500 mg/d) for the first 2 years of treatment. Tamoxifen was administered at 40 mg/d for the first 2 years and at 20 mg/d for 3 years.

RESULTS: All randomized and eligible patients were included in the analysis according to the intention-to-treat principle. After a median follow-up of 5.3 years, the 5-year disease-free survival in the aminoglutethimide plus tamoxifen group was 83.6% versus 83.7% in the monotherapy group (P =.89). The corresponding data for overall survival at 5 years were 91.4% and 91.2%, respectively (P =.74). More patients failed to complete combination treatment (13.7%) because of side effects as compared to tamoxifen alone (5.2%; P =.0001).

CONCLUSION: Aminoglutethimide given for 2 years in addition to tamoxifen for 5 years does not improve the prognosis of postmenopausal patients with receptor-positive, lymph node-negative or lymph node-positive breast cancer.

J Clin Oncol 21:984-990, 2003

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Sequential steroid hormone receptor measurements in primary breast cancer with and without intervening primary chemotherapy

Taucher S, Rudas M, Gnant M, Thomanek K, Dubsky P, Roka S, Bachleitner T, Kandioler D, Wenzel C, Steger G, Mittlböck M, Jakesz R.

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Abstract

The objective of this analysis was to determine the accuracy of steroid receptor measurement in large core needle biopsies compared with surgically removed specimens and the influence of preoperative chemotherapy on hormone receptor status. We consecutively performed 722 large core needle biopsies in palpable lesions of the breast. The diagnosis of breast cancer was confirmed upon biopsy in 450 patients; 236 women underwent immediate surgery, and 214 patients received preoperative chemotherapy. We assessed estrogen (ER) and progesterone receptor (PR) in biopsy tissue and surgically removed specimens and calculated accuracy, sensitivity, specificity, the weighted kappa value and Spearman’s rank correlation. The modulation of steroid receptor status in preoperatively treated patients was tested by Cochran-Mantel-Haenszel statistics. The accuracy of ER evaluation in the biopsy material of patients without intervening chemotherapy was 91%, sensitivity and specificity were 94% and 80% respectively. Accuracy, sensitivity and specificity were 86% in patients treated preoperatively. In terms of PR assessment, we obtained slightly inferior results: accuracy, sensitivity and specificity were 80%, 73% and 85% respectively in patients without preoperative treatment, and 79%, 48% and 92% respectively in patients undergoing preoperative therapy. Following preoperative chemotherapy, patients showed a significant increase in ER-negative (P=0.02) and PR-negative (P=0.0005) measurements. We have concluded from our results that ER and PR receptor measurement in core needle biopsy is a reliable basis in clinical practice for selecting patients for neoadjuvant endocrine treatment. Preoperative cytotoxic chemotherapy induced a significant extent of variation in the steroid receptor expression of breast cancer cells.

Endocrine-Related Cancer (2003) 10 91–98

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