Adjuvant chemotherapy in 780 patients with early breast cancer: 10-year data from Saudi Arabia

• Published in: Medical oncology (Northwood, London, England) London, England), 2005, Vol.22 (4), p.343-352
• Main Authors: Ibrahim, Ezzeldin M, Ezzat, Adnan A, Rahal, Mohammed M, Raja, Madras M, Ajarim, Dahish S
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - mortality; Breast Neoplasms - surgery; Chemotherapy, Adjuvant; Cyclophosphamide - administration & dosage; Disease-Free Survival; Doxorubicin - administration & dosage; Female; Fluorouracil - administration & dosage; Humans; Methotrexate - administration & dosage; Middle Aged; Oncology; Paclitaxel - administration & dosage; Prognosis; Radiotherapy, Adjuvant; Retrospective Studies; Saudi Arabia; Selective Estrogen Receptor Modulators - therapeutic use; Tamoxifen - therapeutic use; Treatment Outcome
• ISSN: 1357-0560; 1357-0560; 1559-131X
• DOI: 10.1385/MO:22:4:343

By and large, data about adjuvant chemotherapy for breast cancer in the Middle East are lacking. Retrospective analysis of prospectively captured data from a main referral center in the Kingdom of Saudi Arabia (KSA) may shed some light on the clinicopathological features and survival of patients offered adjuvant chemotherapy in a similar population in that part of the world. Data on patients with invasive breast cancer (Stages I to IIIA) seen between 1992 and the end of 2001 and who received adjuvant chemotherapy were analyzed. A total of 780 patients were considered eligible and constitute the basis of this report. The median age +/- SD of the 780 patients was 42 +/- 9.6 yr. The majority of patients were younger than 50 yr (78%) and premenopausal (83%). Ten percent, 69%, and 21% of patients had Stage I, II, and IIIA, respectively. Patients expressed relatively high prevalence of adverse clinicopathological characteristics. Most patients (523 patients, 67%) received anthracyclines-containing adjuvant chemotherapy, 610 patients (78%) received adjuvant radiotherapy, and 296 (38%) received adjuvant tamoxifen. At a median follow-up of 42 mo (95% CI, 38.1-62.8 mo), the median overall (OS) and disease-free survival (DFS) were not reached; however, the 5-yr actuarial survival was estimated as 74% and 59%, respectively. Cox proportional regression hazard model identified positive axillary nodal status, and positive vascular invasion are the only variables that influenced OS adversely. The model also distinguished the same variables plus negative estrogen receptor status as covariates with negative effect on DFS. In conclusion, this series of 780 predominantly young patients with breast cancer receiving adjuvant chemotherapy highlighted the disease patterns and survival outcome in the KSA. The current series is significant being one of the few reports about adjuvant chemotherapy experience in a developing country and certainly the first from that part of the world.