scholarly journals Διερεύνηση της προγνωστικής αξίας του επιπέδου έκφρασης της πρωτεΪνης MCT4 στο στρώμα που περιβάλλει τα καρκινικά κύτταρα αδενοκαρκινωμάτων παχέος εντέρου και ορθοκολικών ηπατικών μεταστάσεων

2016 ◽  
Author(s):  
Χρίστος Πετρίδης

Σκοπός της εργασίας αυτής είναι ο καθορισμός της προγνωστικής αξίας της μεμβρανικής πρωτεΐνης μεταφοράς μονοκαρβοξυλασών (MCT4) σε ασθενείς με καρκίνο παχέος εντέρου και ηπατικές μεταστάσεις (CRLM). Διερευνήσαμε τη συσχέτιση μεταξύ της έκφρασης της MCT4 στους ασθενείς με CRLM και της συνολικής επιβίωσης (overall survival-OS) καθώς επίσης και του διαστήματος ελευθέρου νόσου (Disease Free Survival – DFS). Η μελέτη της έκφρασης της MCT4 έγινε τόσο στα κύτταρα του στρώματος που περιβάλλουν τις ηπατικές μεταστάσεις και ειδικότερα στους ινοβλάστες που σχετίζονται με τον καρκίνο (CAFs) όσο και στα ίδια τα καρκινικά κύτταρα. Ο πληθυσμός της μελέτης αφορούσε ασθενείς με καρκίνο στο παχύ έντερο οι οποίοι είχαν μεταστατική νόσο μόνο στο ήπαρ χωρίς οποιαδήποτε άλλη εξωηπατική εντόπιση.ΜέθοδοςΠρόκειται για μια αναδρομική έρευνα κατά την οποία χρησιμοποιήθηκαν τα κλινικά αρχεία και τα ιστολογικά παρασκευάσματα 107 ασθενών με καρκίνο παχέος εντέρου και ηπατικές μεταστάσεις. Η ανίχνευση και καθορισμός της έκφρασης της MCT4 πραγματοποιήθηκε με τη χρήση ανοσοϊστοχημείας η οποία αξιολογήθηκε με ημιποσοτική μέθοδο. Δημιουργήθηκαν τελικά δύο ομάδες ασθενών προς σύγκριση της συνολικής τους επιβίωσης (OS) και του διαστήματος ελευθέρου νόσου (DFS). Η πρώτη ομάδα περιλάμβανε τους ασθενείς τους οποίους τα ιστολογικά παρασκευάσματα είχαν ασθενή χρώση για την MCT4 (weak MCT4 expression) και η δεύτερη ομάδα περιλάμβανε αυτούς που παρουσίαζαν ισχυρή χρώση για την MCT4 (strong MCT4 expression). Η στατιστική ανάλυση των αποτελεσμάτων για τη συνολική επιβίωση (OS) και το διάστημα ελεύθερο νόσου (DFS) περιλάμβανε τόσο τη μέθοδο Kaplan-Meier όσο και πολυπαραγοντικές μεθόδους ανάλυσης ( Cox-regression methods).ΑποτελέσματαΤα ιστολογικά δείγματα από CLRΜ των 57 ασθενών (53,27%) παρουσίασαν ασθενή χρώση των κυττάρων του στρώματος ως προς την MCT4 σε αντίθεση με τα δείγματα 50 ασθενών (46,73%) τα οποία παρουσίασαν ισχυρή χρώση των κυττάρων του στρώματος για την MCT4. Από την στατιστική ανάλυση που ακολούθησε οι ασθενείς οι οποίοι εμφάνιζαν ισχυρή χρώση για την MCT4 είχαν μειωμένο διάστημα ελεύθερο νόσου - DFS (HR 1.79; 95%CI, 1.12-2.85; P=0,014) καθώς επίσης και μειωμένη συνολική πενταετή επιβίωση - OS (HR 3.81 95%CI, 1.88-7.72; P<0,001) στην μονοπαραγοντική ανάλυση διακύμανσης. Η συσχέτιση αυτή παρέμεινε στατιστικά σημαντική και κατά τη διενέργεια της πολυπαραγοντικής ανάλυσης για το διάστημα ελεύθερο νόσου – DFS και για τη συνολική πενταετή επιβίωση - OS (HR 1.95; 95% CI, 1.19-3.17; P=0.007, και HR 4.38; 95%CI, 2.15-8.92; P<0.001 αντίστοιχα). Το ποσοστό έκφρασης της MCT4 στα καρκινικά κύτταρα δεν συσχετίζεται με το διάστημα ελεύθερο νόσου – DFS και τη συνολική πενταετή επιβίωση - OS στους ασθενείς με CRLM. Το διάστημα ελεύθερο νόσου – DFS και η συνολική πενταετής επιβίωση - OS για τους ασθενείς με ασθενή χρώση στα κύτταρα του στρώματος για την MCT4 ήταν 43% και 78% ενώ τα αντίστοιχα ποσοστά για τους ασθενείς που εμφανίζαν ισχυρή χρώση για την MCT4 ήταν 15% and 37% αντίστοιχα. ΣυμπέρασμαΤα αποτελέσματα της παρούσας μελέτης συνδέουν την ισχυρή έκφραση της MCT4 στα κύτταρα του στρώματος (και ειδικότερα στους ινοβλάστες-CAFs) με χειρότερη συνολική επιβίωση και συχνότερες υποτροπές στους ασθενείς με καρκίνο παχέος εντέρου και ηπατικές μόνο μεταστάσεις. Τα αποτελέσματα αυτά πρέπει να επικυρωθούν και με άλλες μελέτες για να μπορέσει η MCT4 να καθιερωθεί ως προγνωστικός δείκτης στον CRLM και παράλληλα πρέπει να μελετηθεί η ανάπτυξη αναστολέων της MCT4 οι οποίοι θα μπορούσαν να χρησιμοποιηθούν συνεργικά με τα υπάρχοντα χημειοθεραπευτικά σχήματα για μείωση του κυτταρικού πολλαπλασιασμού και του μεταστατικού δυναμικού των καρκινικών κυττάρων. Η στοχοποίηση με μικρά μόρια-αναστολείς του κυτταρικού μεταβολισμού μπορεί να επιφέρει θετικά ευεργετικά αποτελέσματα στους ασθενείς με κακοήθεια.

2021 ◽  
Author(s):  
Bertrand Baussart ◽  
Chiara Villa ◽  
Anne Jouinot ◽  
Marie-Laure Raffin-Sanson ◽  
Luc Foubert ◽  
...  

Objective: Microprolactinomas are currently treated with dopamine agonists. Outcome information on microprolactinoma patients treated by surgery is limited. This study reports the first large series of consecutive non-invasive microprolactinoma patients treated by pituitary surgery and evaluates the efficiency and safety of this treatment. Design: Follow-up of a cohort of consecutive patients treated by surgery. Methods: Between January 2008 and October 2020, 114 adult patients with pure microprolactinomas were operated on in a single tertiary expert neurosurgical department, using an endoscopic endonasal transsphenoidal approach. Eligible patients were presenting a microprolactinoma with no obvious cavernous invasion on MRI. Prolactin was assayed before and after surgery. Disease-free survival was modeled using Kaplan-Meier representation. A cox regression model was used to predict remission. Results: Median follow-up was 18.2 months (range: 2.8 to 155). In this cohort, 14/114 (12%) patients were not cured by surgery, including 10 early surgical failures, and 4 late relapses occurring 37.4 months (33 to 41.8) after surgery. From Kaplan Meier estimates, 1-year and 5-year disease free survival were 90.9% (95% CI, 85.6%-96.4%) and 81% (95% CI,71.2%-92.1%) respectively. The preoperative prolactinemia was the only significant preoperative predictive factor for remission (P<0.05). No severe complication was reported, with no anterior pituitary deficiency after surgery, one diabetes insipidus, and one postoperative cerebrospinal fluid leakage properly treated by muscle plasty. Conclusions: In well selected microprolactinoma patients, pituitary surgery performed by an expert neurosurgical team is a valid first-line alternative treatment to dopamine agonists.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3550-3550
Author(s):  
Karsten Schulmann ◽  
Sven Koepnick ◽  
Christoph Engel ◽  
Christiane Bernhardt ◽  
Verena Steinke ◽  
...  

3550 Background: Previous studies showed conflicting results regarding the value of ACT in MSI-H CC. A recent study reported differential benefits from 5-FU-based ACT comparing suspected sporadic vs suspected hereditary MSI-H CC. We sought to evaluate the prognostic impact of ACT in a large cohort of Lynch syndrome (LS) patients (pts) with stage II CC. Methods: To minimize selection bias diagnoses >2 years prior to registration in the database of the German HNPCC consortium were excluded. 278 patients (61% male, mean age 42.9y, 13% stage IIB, 51% with MMR gene mutation) were eligible. Overall Survival (OS), CC-specific Survival (CSS), and Disease Free Survival (DFS) were analyzed using Kaplan-Meier and Cox Regression analyses. Results: 5y OS, CSS and DFS were 95%, 95% and 93% respectively. Right-sided CC was independently associated with lower DFS in stage II and IIA. Increasing age was associated with lower OS, CSS and DFS in stage IIA, however we observed only trends in the multivariate analysis. Surgery alone (without ACT) was associated with a slightly lower OS in stage IIA (univariate HR 3,659; 95% CI 0,81-16,5; P=0.092); but not with lower DFS and CSS. Prognosis was not different comparing FOLFOX vs. 5-FU-based ACT. Conclusions: Our data suggest that LS pts with stage II CC do not benefit from ACT. FOLFOX was not superior to 5-FU-based ACT. If our results are confirmed, LS pts with stage IIA CC should not receive ACT. The group of stage IIB CC was too small to make definite conclusions. [Table: see text]


Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4193-4193
Author(s):  
Dok Hyun Yoon ◽  
Byeong Seok Sohn ◽  
Jung Yong Hong ◽  
Sung Yong Oh ◽  
Won-Sik Lee ◽  
...  

Abstract Introduction: Full cycles of R-CHOP chemotherapy or abbreviated chemotherapy followed by radiotherapy are recommended as standard of care for limited stage (LS) diffuse large B-cell lymphoma (DLBCL). There are occasions when lesions are completely excised during the diagnostic surgical resection. In addition, initial surgical resection of the involved area is often performed in the treatment of intestinal lymphomas with LS disease due to obstructive lesions or perforation risk. As to these patients without residual gross lesions, however, the number of cycles of chemotherapy has not so far been questioned and full cycles of chemotherapy are usually performed. Thus, we aimed to investigate the effectiveness of an abbreviated three courses of R-CHOP chemotherapy in patients with completely excised stage I or II CD20+ DLBCL. Methods: This is a multicenter, single arm, phase 2 study designed to evaluate efficacy and safety of 3 cycles of R-CHOP chemotherapy in low risk LS DLBCL. Key inclusion criteria were as follows: pathologically confirmed CD20 positive DLBCL, age >18 years, stage I or II, and complete resection with no residual lesion after surgical resection. Patients with B symptoms, bulky disease, primary breast, testicular or CNS lymphomas were excluded. R-CHOP chemotherapy started within 6 weeks from surgical resection and was repeated every 3 weeks for 3 cycles. Prophylactic G-CSF was not administered. Radiologic tumor assessment was performed at baseline, every 3 months until 2 years, then every 6 months until 5 years after completion of study treatment. The primary endpoint was 2-year disease-free survival (DFS). Secondary endpoints included overall survival and safety. (ClinicalTrials.gov: NCT01279902.) Results: Twenty-three patients were enrolled between Dec 2010 and May 2013. Of these, one was excluded because of ineligibility and the remaining 22 patients were included in the analysis. The median age at diagnosis was 57 years (range, 29-77 years). Fourteen patients had stage 1 disease and the other eight had stage 2. Preoperative LDH level was available in 11 patients and it was elevated in two of them. Thus, preoperative IPI scores could be calculated in those 11 patients; 0 in 8, 1 in one, and 2 in one patients, respectively. Postoperative IPI scores were 0 in 11, 1 in 10 and 2 in one patients. Primary sites included intestine (n=15), cervical lymph nodes (n=4), stomach (n=1), tonsil (n=1) and spleen (n=1). All the 22 patients completed 3 cycles of R-CHOP chemotherapy as planned. With a median follow-up of 39.5 months (95% CI, 29.9-47.1 months), only one patient showed disease progression and died with the estimated 2-year DFS and OS rates of 95.0%. It was the only one patient with IPI of 2 with elevated LDH and age>60 that showed disease progression at 12.7 months. He had a splenic mass and underwent splenectomy followed by 3 cycles of R-CHOP. He underwent one cycle of salvage R-ESHAP chemotherapy but died of rapid disease progression. No grade 3 or 4 non-hematologic toxicities were observed. Neutropenia was the most common grade 3 or 4 hematologic toxicity which was noted in 8 (36.4%) patients. Three patients experienced G3 febrile neutropenia. Conclusions: Three cycles of abbreviated R-CHOP chemoimmunotherapy is an effective and safe therapeutic approach for patients with localized and completely excised DLBCL especially in those with low-risk IPI. Figure 1 Kaplan-Meier curves of (A) disease-free survival and (B) overall survival. (A) (B) Figure 1. Kaplan-Meier curves of (A) disease-free survival and (B) overall survival. / (A). / (B) Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.


2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 512-512 ◽  
Author(s):  
John Hogan ◽  
Georges Samaha ◽  
John Burke ◽  
David Waldron ◽  
Eoin Condon ◽  
...  

512 Background: Debate persists regarding the relationship between mucin production and cancer-related outcome following curative resection for colon cancer. Lack of consensus is due to (amongst other factors) discrepancies in definition, small cohort studies and the integration of both colon and rectal cancers. This study characterizes the relationship between mucin production and cancer-related outcome in an homogenous single-institute based cohort. Methods: A database spanning demographics, clinico-pathologic characteristics and prognostic factors was generated for all patients undergoing curative-intent colonic resection in the interval 2000 to 2010. Patients were categorized simply as mucin producing (i.e. MC) or non-mucin producing adenocarcinoma (NMC). Primary outcomes included overall survival (time to death from any cause) and disease free survival (time to loco-regional and systemic recurrence). Trends were established for MC and NMC using Kaplan-Meier estimates, plotted and compared using log-rank analysis. Findings significant on univariate analysis were incorporated into multivariate analysis. Cox proportional hazards model was employed to determine the associated hazard of both death and disease recurrence in each group. Statistical analysis was performed using R version 2.15. P < 0.05 was considered significant. Results: 77 mucinous carcinomas (MC) and 358 non mucinous carcinomas (NMC) were included. On univariate analysis, MC was associated with improved overall survival (OS) (P=0.007). Both N1 (HR 1.625, P=0.011) and N2 (HR 2.7, P<0.001) status were associated with adverse OS. On multivariate analysis, MC approached but did not reach statistical significance for improved OS (HR 0.543, P=0.061). A comparison of Kaplan-Meier estimates for overall survival in MC and NMC groups indicated that OS was significantly improved in the MC cohort (P=0.011). There was no difference in disease free survival (P=0.224). Systemic recurrence was greater in the NMC group (P=0.042). Conclusions: Mucin production in colonic adenocarcinoma appears associated with improved overall but not disease-free survival. In addition, the absence of mucin was associated with adverse systemic but not local recurrence.


2011 ◽  
Vol 125 (5) ◽  
pp. 509-512 ◽  
Author(s):  
S E Lester ◽  
M H Rigby ◽  
S M Taylor

AbstractObjective:To report the results of transoral laser microsurgery for the treatment of early glottic cancer at our institution.Design:Cohort study. Retrospective review of charts of patients diagnosed with tumour stage 1 or 2 (early stage; no nodes or metastases), previously untreated, primary glottic cancer, treated with transoral laser microsurgery at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. The minimum follow-up period was two years.Setting:Tertiary care head and neck cancer centre.Participants:Fifty-three patients treated between January 2002 and November 2007.Outcome measure:Kaplan–Meier survival analysis for disease-free survival, overall survival and laryngectomy-free survival, at five years.Results:The group comprised 46 men and seven women, with a mean age of 66 years (range 30–84 years). Mean follow up was 40 months (range 12–89 months). There were four cases of complications (7.5 per cent). Kaplan–Meier survival analysis revealed a five-year disease-free survival (including salvage) of 96.2 per cent, a five-year overall survival (all causes) of 88.8 per cent and a five-year laryngectomy-free survival of 98.1 per cent.Conclusion:Transoral laser microsurgery is a safe and effective initial treatment for early laryngeal cancer, and has high rates of laryngeal preservation and disease-free survival.


Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Marcus L. Ware ◽  
David A. Larson ◽  
Penny K. Sneed ◽  
William W. Wara ◽  
Michael W. McDermott

Abstract OBJECTIVE Recurrent atypical and malignant meningiomas are difficult to treat successfully. Chemotherapy to date has been unsuccessful, and radiosurgery is limited to smaller tumors. Reoperation alone provides limited tumor control and limited prolonged survival. The addition of brachytherapy at the time of operation is an option. Here, we report the results of our series of patients with recurrent malignant meningioma treated with resection and brachytherapy with permanent low-dose 125I. METHODS The charts of patients in our database with recurrent atypical and malignant meningiomas treated by surgical resection and permanent 125I brachytherapy at the University of California, San Francisco, between 1988 and 2002 were selected for this study. Calculations of disease-free survival and overall survival curves were made by the Kaplan-Meier actuarial method. Univariate analysis between Kaplan-Meier curves was based on the log-rank statistic, with a significance level set at a value of P ≤ 0.05. RESULTS Seventeen patients had recurrent malignant meningioma, and four had recurrent atypical meningioma. The median number of sources implanted after surgical resection was 30 (range, 4–112 sources), with a median total activity of 20 mCi (range, 3.3–85.9 mCi). The median time to progression after brachytherapy was 11.6 months for patients with malignant meningioma and 10.4 months for the combined group. There was a trend toward longer disease-free survival time in patients after gross total resection versus subtotal resection and in patients with tumors located at the convexity and parasagittally versus at the cranial base. These differences did not reach statistical significance. The median overall survival after diagnosis was 9.4 years for patients with atypical meningioma, 6.6 years for those with malignant meningioma, and 8.0 years for all patients combined. Survival from the time of resection and implantation of 125I was 1.6 years for patients with atypical meningioma, 2.4 years for patients with malignant meningioma, and 2.4 years for the combined group. Thirty-three percent of patients had complications requiring surgical intervention. Radiation necrosis occurred in 27% of patients; 13% underwent surgery for radiation necrosis. In addition, 27% had a wound breakdown and required surgical intervention. CONCLUSION The options for patients with recurrent atypical or malignant meningiomas are limited. Our results suggest that for tumors not suitable for radiosurgery, resection followed by permanent brachytherapy should be considered as a potential salvage treatment. However, this approach results in a relatively high complication rate in these heavily treated patients and requires meticulous surgical technique and medical therapies to assist with wound healing after surgery.


2021 ◽  
Vol 10 (6) ◽  
pp. 1155
Author(s):  
Jan-Paul Gundlach ◽  
Stephan Schmidt ◽  
Alexander Bernsmeier ◽  
Rainer Günther ◽  
Victor Kataev ◽  
...  

Liver transplantation (LT) is routinely performed for hepatocellular carcinoma (HCC) in cirrhosis without major vascular invasion. Although the adverse influence of microvascular invasion is recognized, its occurrence does not contraindicate LT. We retrospectively analyzed in our LT cohort the significance of microvascular invasion on survival and demonstrate bridging procedures. At our hospital, 346 patients were diagnosed with HCC, 171 patients were evaluated for LT, and 153 were listed at Eurotransplant during a period of 11 years. Among these, 112 patients received LT and were included in this study. Overall survival after 1, 3 and 5 years was 86.3%, 73.9%, and 67.9%, respectively. Microvascular invasion led to significantly reduced overall (p = 0.030) and disease-free survival (p = 0.002). Five-year disease-free survival with microvascular invasion was 10.5%. Multilocular tumor occurrence with simultaneous microvascular invasion revealed the worst prognosis. In our LT cohort, predominant bridging treatment was transarterial chemoembolization (TACE) and the number of TACE significantly correlated with poorer overall survival after LT (p = 0.028), which was confirmed in multiple Cox regression analysis for overall and disease-free survival (p = 0.015 and p = 0.011). Microvascular tumor invasion is significantly associated with reduced prognosis after LT, which is aggravated by simultaneous occurrence of multiple lesions. Therefore, indication strategies for LT should be reconsidered.


2020 ◽  
Vol 9 (1S) ◽  
Author(s):  
Magdi Ayuza ◽  
Wirsma Arif Harahap ◽  
Rony Rustam ◽  
Richvan Dana Nindrea

Kanker Payudara (KPD) pada usia muda memiliki keistimewaan karakteristik. Rekurensi KPD dipengaruhi oleh berbagai faktor antara lain faktor klinis, regimen terapi dan biomolekuler dari tumor itu sendiri. Berbagai macam modalitas terapi KPD, namun masih terdapat risiko terjadinya rekurensi terutama pada pasien dewasa muda. Tujuan: Mengetahui faktor-faktor yang mempengaruhi Disease Free Survival (DFS) dan Overall Survival (OS) pada pasien KPD usia muda di Kota Padang. Metode: Penelitian ini menggunakan desain cohort study retrospectif pada pasien KPD usia muda yang telah mendapatkan pengobatan KPD yang memenuhi kriteria inklusi sebanyak 103 sample yang terdapat pada data register KPD PERABOI Padang. Analisis survival menggunakan Kaplan Meier dengan Log Rank Test. Apabila diperoleh nilai p < 0,05, maka terdapat hubungan bermakna. Hasil: Terdapat perbedaan antara setiap faktor klinis, faktor biomolekuler dan faktor terapi dalam hal rata-rata DFS maupun rata-rata OS, namun tidak terdapat pengaruh yang bermakna secara analisis statistik antara faktor terapi (terapi hormon, radioterapi dan terapi target) terhadap DFS dan OS pada pasien kanker payudara usia muda di Kota Padang (p>0,05). Terdapat pengaruh dari pemberian kemoterapi terhadap DFS pada pasien kanker payudara usia muda di Kota Padang (p<0,05). Simpulan: Tidak terdapat hubungan yang bermakna antara faktor klinis dan faktor biomolekuler dengan DFS dan OS, namun terdapat hubungan bermakna antara pemberian kemoterapi dengan DFS dan OS pada penderita KPD usia muda di kota Padang tahun 2008 – 2018.


2021 ◽  
Author(s):  
Tailai An ◽  
Lingna Deng ◽  
Yan Wang ◽  
Zheng Yang ◽  
Cuicui Chai ◽  
...  

Aim: To assess the prognostic impacts of PABPC1 on gastric cancer (GC) patients. Methods: The expression levels of PABPC1 in GC tissues and normal gastric tissues were initially compared via bioinformatics analysis. Immunohistochemical staining was accomplished to assess the expression of PABPC1 in the included GC patients. Then the impacts of PABPC1 expression on survival of GC patients were evaluated by Cox regression and Kaplan–Meier analyses. Results: The expression levels of PABPC1 in gastric tissues were significantly higher than those in normal gastric tissues (paired, p = 0.002; unpaired, p = 3.60e-9). By Kaplan–Meier, it was demonstrated that high expression of PABPC1 was significantly associated with worse overall and disease-free survival. Furthermore, high PABPC1 expression was demonstrated to be an independent predictive factor for both overall (p = 0.013; hazard ratio = 2.058; 95% CI: 1.162–3.644) and disease-free (p = 0.018; hazard ratio = 2.284; 95% CI: 1.153–4.524) survival. Conclusion: PABPC1 is a potential prognostic biomarker for GC patients.


2018 ◽  
Vol 7 ◽  
pp. 25
Author(s):  
M. Al Farisyi ◽  
Daan Khambri

semua wanita yang didiagnosa kanker payudara. KPD usia muda berhubungan dengan progresifitas yang tinggi, kecenderungan untuk rekurensi dan prognosis yang lebih buruk dibandingkan KPD usia tua. Penelitian ini bertujuan untuk menilai outcome dari pasien KPD usia muda yang mendapatkan pengobatan di RSUP Dr. M. Djamil Padang dari tahun 2008-2017. Desain penelitian ini adalah kohort retrospektif dengan analisis data menggunakan Kaplan Meier dengan Log Rank, pada 71 pasien yang telah didiagnosis KPD secara histopatologi dan mendapatkan terapi (bedah, kemoterapi, radioterapi, hormonal terapi ataupun targetting terapi). Hasil penelitian menunjukkan insiden KPD terbanyak pada range usia 35-40 tahun, dengan ukuran tumor T3, diferensiasi derajat sedang, histopatologi tipe duktal karsinoma dengan Triple Negative Breast Cancer (TNBC) sebagai subtipe yang terbanyak. Disease Free Survival (DFS) didapatkan rata-rata 87.48 bulan dan Overall Survival (OS) sebesar 79.13 bulan. Ukuran tumor didapatkan sebagai faktor yang berhubungan terhadap DFS (p = 0.00).


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