Longer Survival in Patients with Breast Cancer with Cyclin D1 Over- Expression after Tumor Recurrence: Longer, but Occupied with Disease

다국어 초록 (Multilingual Abstract)

Purpose: The effect of cyclin D1 overexpression on breast canceroutcomes and prognosis is controversial, even though amplificationof the cyclin D1 gene, CCND1, has been shown to be associatedwith early relapse and poor prognosis. In this study, we examinedthe relationship between cyclin D1 overexpression anddisease-specific survival (DSS). We also analyzed survival in patientswho experienced recurrence. Methods: We retrospectivelyanalyzed data from patients diagnosed with ductal carcinomabetween April 2005 and December 2010. We examined clinicopathologicfactors associated with cyclin D1 overexpression andanalyzed the influence of cyclin D1 on recurrence-free survivaland DSS. Results: We identified 236 patients diagnosed with primarybreast cancer who completed all phases of their primarytreatment. Cyclin D1 overexpression was significantly associatedwith longer DSS (5-year DSS, 89.9% in patients without cyclin D1overexpression vs. 98.9% in patients with cyclin D1 overexpression;p=0.008). Multivariate analysis also found that patients withcyclin D1 overexpressing tumors had significantly longer diseasespecificsurvival than patients whose tumors did not overexpresscyclin D1, with a hazard ratio for disease-specific mortality of 7.97(1.17–54.22, p=0.034). However, in the group of patients whoexperienced recurrence, cyclin D1 overexpression was not significantlyassociated with recurrence-free survival. Cyclin D1 overexpressionwas significantly associated with increased survivalafter disease recurrence, indicating that cyclin D1 overexpressionmight be indicative of more indolent disease progression aftermetastasis. Conclusion: Cyclin D1 overexpression is associatedwith longer DSS, but not recurrence-free survival, in patients withbreast cancer. Longer postrecurrence survival could explain theapparent inconsistency between DSS and recurrence-free survival.
Patients with cyclin D1-overexpressing tumors survive longer,but with metastatic disease after recurrence. This informationshould spark the urgent development of tailored therapies to curethese patients

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