Research

Is the thymidine labeling index a good prognostic marker in breast cancer?

Ebru Sen-Oran^1,4 , Vahit Ozmen¹ , Ayhan Bilir² , Neslihan Cabioglu¹ , Mahmut Muslumanoglu¹ , Abdullah Igci¹ , Nese Guney³ and Mustafa Kecer¹

¹Departments of General Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey

²Department of Histology and Embryology, Istanbul Medical School, Istanbul University, Istanbul, Turkey

³Department of Oncology, Istanbul Medical School, Istanbul University, Istanbul, Turkey

⁴Department of Surgery, Memorial Hospital, Istanbul, Turkey

author email corresponding author email

World Journal of Surgical Oncology 2007, 5:93doi:10.1186/1477-7819-5-93

Published:	19 August 2007

Abstract

Background

The aim of the present study was to determine the prognostic relevance of thymidine labeling index (TLI) in patients with breast cancer.

Methods

TLI of the primary tumor was measured in 268 patients at the time of the surgical biopsy by an in vitro method.

Results

Fifty-four patients had stage I disease, and 138 patients had stage II disease, and 76 patients had stage III disease. One hundred-four patients were found to have low TLI-index (<3%), and 164 patients had high TLI-index (≥3%). The median follow-up was 71.5 months (range, 6–138 months). The 5-year overall survival (OS) and disease free survival (DFS) rates was 84% and 74%, respectively. Lymph node involvement, tumor size more than 2 cm, high nuclear grade and estrogen receptor negativity were found to be associated with poorer DFS and OS rates. On subgroup analysis, however, the 5-year OS rate was significantly higher in the low TLI-group than in the high TLI-group in patients with stage I disease (100% vs 76%, p = 0.05).

Conclusion

Our findings suggest that the prognostic significance of TLI appears to be limited to early breast cancer that might help to distinguish patients who need more aggressive adjuvant treatment.