The prognostic predictors for disease free survival and overall survival in stage I-III breast cancer patients treated with adjuvant cyclophosphamideadriamycin-5-fluorouracil (CAF) chemotherapy

Anthracycline-containing regimens today are considered as the standard chemotherapy for high-risk breast cancer patients. The aim of this study was to retrospectively evaluate the survival, prognostic factors and side effects of adjuvant cyclophosphamide-adriamycin-5-fluorouracil (CAF) chemotherapy in breast cancer patients. Between 1987 and 2000, 248 breast cancer patients were treated with CAF chemotherapy. The mean age of the patients were 44.6 years (range: 21-75). The majority of the patients were premenopausal (71%). Estrogen receptor positivity was 48% in 151 patients. Progesterone receptor positivity was 47% in 130 patients. According to TNM classification 3.6%, 59.3% and 34.7% of the patients were at stage I, II and III, respectively. During the median follow-up time of 24.1 months (range: 4.8-156.2), the median disease free survival (DFS) was 63.1 months. In univariate analyses statistically significant predictors for DFS were age, nodal status, multicentricity and receptor status; and for overall survival (OS) were nodal status and receptor status. In multivariate analyses, the number of metastatic lymph nodes was the most significant independent prognostic factor for DFS and OS. While the age was another independent factor for DFS, the receptor status was an independent prognostic factor for OS. The most frequent side effects were fatigue (92%), grade 3 alopecia (84.7%) and grade 3 nausea/vomitting (65.3%). The number of the metastatic lymph nodes, especially when more than 3, revealed to be the most significant prognostic factor in patients treated with CAF. CAF is a well-tolerated combination with few side effects.