Ten-year results from the National Surgical Adjuvant Breast and Bowel Project (NSABP) clinical trial evaluating the use of @entity10841 mustard ( @entity3601 ) in the management of primary XXXX .

@entity1 @entity0 @entity5 @entity10841 @entity3601
Between 1972 and 1974, @entity1 were entered into a National Surgical Adjuvant Breast and Bowel Project (NSABP) trial to evaluate @entity10841 mustard ( @entity3601 ) as an adjuvant to mastectomy in @entity1 with primary @entity0 and pathologically positive axillary nodes. Overall, findings through 10 years of observation indicate an 8% difference in disease-free survival (DFS) (P = .06) and a 5% difference in survival (P = .4). @entity1 less than or equal to 49 years of age who received @entity3601 demonstrate a significant (P = .03) prolongation of DFS and a significant (P = .05) survival benefit compared with those who received a placebo. There is a 37% reduction in their mortality and a cumulative odds of survival of 1.67. In that age group, both those with one to three and greater than or equal to 4 positive nodes benefited, but the advantage was greater when there were fewer positive nodes. There was a significant (P = .009) reduction in mortality (64%) and a cumulative odds of survival of 3.25 in @entity1 less than or equal to 49 years old with one to three positive nodes. No advantage from @entity3601 was observed in @entity1 greater than or equal to 50 years old. When @entity3601 response is related to nuclear grade, a marker of @entity5 differentiation, there is a highly significant improvement in DFS (less than .001), distant DFS (.001), and survival (.004) through 10 years of observation for all @entity1 with @entity5 classified as nuclear grade poor (poorly differentiated), regardless of age and nodal status. Mortality was reduced by 32% and the cumulative odds of survival was 2.10 at 10 years. Of singular importance is the observation of a benefit in those greater than or equal to 50 years of age as well as in those less than or equal to 49 years of age with poorly differentiated @entity5 . There is a significant (P = .003) survival benefit for those in the older age group with a 37% reduction in mortality, and a cumulative odds of survival of 2.75. @entity1 in both age groups with well-differentiated @entity5 demonstrated no benefit from @entity3601 . Those who are older seem to do less well following chemotherapy. We conclude that @entity5 differentiation is a better discriminant of response to chemotherapy than is age, and that both younger and older @entity1 are responsive to adjuvant chemotherapy when they have poorly differentiated @entity5 .
