PROGNOSTIC-SIGNIFICANCE OF P53, ANGIOGENESIS, AND OTHER CONVENTIONAL FEATURES IN OPERABLE BREAST-CANCER - SUBANALYSIS IN NODE-POSITIVE AND NODE-NEGATIVE PATIENTS

To validate the prognostic value of the determination of p53 expressio n, intratumoral microvessel density (IMD) (a measure of angiogenesis), and the conventional features, we studied 531 patients operated of br east cancer (271 node-positive and 260 node-negative), with a median f ollow-up exceeding 6 years. IMD was assessed by using the anti-CD31 an tibody to identify the microvessels. p53, estrogen receptor (ER) and p rogesterone receptor (PgR) were determined by immunocytochemistry usin g the antibodies PAb1801, H-222 Sp2y and KD-68, respectively. The prog nostic value of the markers was analyzed by univariate and multivariat e statistical analyses. In the overall series p53 expression, IMD, nod al status, ER and PgR were statistically significant prognostic indica tors for both relapse-free survival (RFS) and overall survival (OS) in the final multivariate model. Likewise, tumor size and menopausal sta tus were significant prognostic indicators for RFS and OS, respectivel y. In the subgroup of node-negative patients who did not receive adjuv ant therapy only p53, IMD, and tumor size were statistically significa nt in multivariate analysis. In the subgroup of node-positive patients treated with adjuvant chemotherapy, IMD, the number of involved nodes and PgR were statistically significant in multivariate analysis. In t he subgroup of node-positive patients treated with adjuvant tamoxifen, IMD and ER (and the number of involved nodes, only for OS) were stati stically significant for both RFS and OS in the final multivariate mod el. Different markers played a diverse prognostic role in the diverse subgroups studied. Angiogenesis was the sole marker which retained pro gnostic value in all the sub-groups analyzed. p53 retained significanc e only in the subgroup of node-negative patients, whilst ER and PgR we re statistically significant in the subgroups of node-positive patient s treated with adjuvant hormone therapy or chemotherapy, respectively.