Factors influencing the prognostic role of oestrogen and progesterone receptor levels in breast cancer - results of the analysis of 670 patients with 11 years of follow-up

In the last two decades, the prognostic role of the steroid hormone receptors has been the subject of a myriad of publications. Nevertheless, its relevance after long-term follow-tip is still not clear. The confusion about the prognostic value is mainly due to the difficulty in comparing analyses. Despite different study-designs and statistical approaches, oestrogen (ER) and progesterone (PR) receptors are widely accepted as prognostic factors. Data front 670 breast cancer patients with a median follow-up Of 11.4 years were analysed retrospectively. ER and PR were measured by the dextran-coated charcoal (DCC) assay. To investigate the time dependence of the prognostic relevance of ER and PR, separate analyses were done for follow-up shorter and longer than 5 years. Special focus was directed at patients less than or equal to 50 and > 50 years, node-negative women, in particular those without adjuvant therapy. Univariate and multivariate analyses were performed. In univariate analysis, ER and PR were associated with a significantly longer overall survival at the cut-off levels 10, 20 or 100 fmol/mg protein. The significant survival benefit Occurred in the first 5 years of follow-up and remained unchanged in the following period. In the multivariate analyses, only the PR was of significant prognostic value (for PR greater than or equal to 20 fmol/mg P = 0.036, for PR greater than or equal to 100 P = 0.01, Cox analysis). In patients younger than 51 years, only PR was an independent prognosticator at the cut-off level of 100 fmol/mg protein, while in patients > 50 years both hormone receptors were not significant. In NO patients, only the PR reached long-term prognostic independence at a cut-off point of greater than or equal to 100 fmol/mg (P = 0.018). 111 addition, in the group of node-negative women less than or equal to 50 years without adjuvant therapy the PR level reached prognostic significance. The hormone receptor status was a prognostic factor only during the first 5 years of follow-up. Our data suggest that age, lymph node status, length of follow-LIP and probably the ER/PR assay are important for the evaluation of ER and PR as prognostic variables. fit most analyses, PR appeared to be superior to ER in predicting the prognosis of primary breast cancer patients. (C) 2002 Elsevier Science Ltd. All rights reserved.