Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Recurrence score”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2026

The 21-gene recurrence score assay as a tool for predicting recurrence risk and guiding adjuvant treatment selection in early breast cancer.

INTRODUCTION: Estrogen receptor-positive (ER+), HER2-negative breast cancer is the most common breast cancer subtype. While adjuvant endocrine therapy reduces recurrence risk, identifying which patients benefit from the addition of chemotherapy remains a key clinical challenge. The Oncotype DX® 21-gene Recurrence Score assay (Exact Sciences, via Genomic Health, Inc.) was developed to address this by quantifying distant recurrence risk and informing chemotherapy decisions in early-stage ER+/HER2- disease. AREAS COVERED: This diagnostic profile reviews the development, validation, and clinical evidence for Oncotype DX, including findings from the TAILORx and RxPONDER prospective trials and the subsequent development of hybrid tools integrating genomic and clinicopathological data. Alternative multiparameter molecular tests (MammaPrint, Prosigna, EndoPredict, Breast Cancer Index) are summarized and compared. We review international guideline recommendations, decision impact studies, cost-effectiveness evidence, and ongoing trials. EXPERT OPINION: Oncotype DX has strong prognostic evidence and has meaningfully reduced chemotherapy use, though its case as a biomarker predictive of therapeutic effect from chemotherapy rests on trial designs with important limitations. Its independent prognostic contribution beyond comprehensive clinicopathological assessment requires further clarification, and cost-effectiveness varies substantially by indication and healthcare setting.

Humans↗
PubMed2026

H&E to recurrence score: A step forward, but not yet a substitute for genomic testing.

Shamai and colleagues developed a multimodal deep-learning model that predicts Oncotype DX recurrence scores from routine H&E slides and clinicopathological variables in hormone receptor‑positive, HER2‑negative early breast cancer. Validated across the TAILORx trial and six external cohorts (over 5000 patients), the model achieved an AUC of 0.898 for identifying recurrence score ≥26 and recapitulated genomic assay patterns of chemotherapy benefit. Notably, 31% of clinically high-risk postmenopausal women were downgraded to low risk by AI, suggesting potential to reduce overtreatment. However, several limitations preclude immediate clinical substitution for genomic testing. First, intratumoural heterogeneity leads to discordant predictions with unclear management guidance. Second, the model's chemotherapy benefit estimates rely on TAILORx's age-based menopausal surrogates, which may not reflect real-world hormonal status or LHRH agonist use. Third, predictive value in node-positive disease remains untested in randomised datasets such as RxPONDER. Additionally, calibration uncertainty near risk thresholds and global scalability issues (including IHC requirements and digital pathology infrastructure) persist. While this represents a landmark step toward democratising precision oncology, the AI tool should currently serve as a complementary decision aid, with genomic testing remaining the gold standard for intermediate, borderline, or discordant cases.

Breast cancer↗
PubMed2026

Oncotype DX: Clinical Utility, Evidence, and Future Trends in Personalized Breast Cancer Management.

The Oncotype DX assay has revolutionized the management of early-stage, hormone receptor-positive, HER2-negative breast cancer. Developed in 2004, it quantifies 21 genes to generate a recurrence score that predicts distant recurrence risk and guides adjuvant chemotherapy. Multiple studies have validated its reliability and clinical utility in enabling more precise risk stratification and individualized treatment planning, thereby minimizing unnecessary chemotherapy exposure and improving patient outcomes. Leading oncology organizations such as the American Society of Clinical Oncology and National Comprehensive Cancer Network have incorporated it into their clinical guidelines. Beyond its well-established role in adjuvant chemotherapy decision-making, Oncotype DX is increasingly being investigated in broader clinical contexts, including lymph node-positive breast cancer, neoadjuvant therapy, radiotherapy, and ductal carcinoma in situ. Ongoing research and technological advancements, such as artificial intelligence-based predictive models and novel biomarker identification, hold significant promise for further enhancing its predictive accuracy and expanding its applications. This review synthesizes current evidence supporting the clinical utility of Oncotype DX, discusses evolving applications, and highlights future directions for integrating this genomic tool into precision oncology practice.

Humans↗
PubMed2025

Partial Breast Irradiation for High Molecular Risk Early-Stage Breast Cancer.

PURPOSE: Partial breast irradiation (PBI) is a suitable and well-tolerated alternative to whole breast irradiation (WBI) following lumpectomy for many forms of low-risk, early-stage breast cancer. Molecular risk scores, such as the Oncotype DX recurrence score (ODX RS), are increasingly guiding systemic treatment decisions. However, molecular/genomic profiling for radiation therapy (RT) decision-making remains investigational, and it is unclear whether a high ODX RS should preclude the use of PBI. We compared oncologic outcomes among patients with high ODX RS (>25) treated with PBI versus WBI. METHODS AND MATERIALS: Patients who underwent breast conservation followed by PBI or WBI with ODX RS > 25 were ascertained from a prospectively maintained institutional database. Comparable PBI and WBI cohorts were generated in 1:5 fashion using propensity score matching based on salient clinicopathologic features. We evaluated the incidence of local recurrence (LR) as a function of RT approach. RESULTS: We identified 968 patients with an ODX RS > 25 who were treated with adjuvant RT, with a median age of 59 years (range, 25-86) and a median 5.3 years of follow-up. In a propensity matched cohort analysis that included 28 patients who received PBI matched to 140 who received WBI, we observed 3 LR events among those receiving PBI (2 of which were in different quadrants from the primary lesion) and 5 events among those receiving WBI. Among this cohort with ODX RS > 25, the 72-month cumulative incidence of LR following PBI was 7.9% (95% CI, 1.3%-23%) compared to 4.8% (95% CI, 1.6%-11%) following WBI (P = .6). CONCLUSIONS: In this cohort of patients with high ODX RS, few LRs were observed, and no statistically significant difference in LR was identified between PBI and WBI. Although these findings suggest that PBI may be considered in carefully-selected high-genomic-risk patients, larger studies with longer follow-up are needed to definitively establish the safety of this approach.

Humans↗
PubMed2026

Development and Validation of a Multimodal Clinical, Pathologic, and Genomic Model for Breast Cancer Recurrence.

PURPOSE: To develop and validate a multimodal recurrence-risk model integrating histology, genomic testing, and clinical variables. METHODS: We developed AI-Path, a whole-slide image biomarker for recurrence prediction trained in CALGB 9344, and validated it in three independent cohorts: TAILORx, a multi-site Chicago cohort, and the MDX-BRCA cohort. We then integrated AI-Path with Oncotype DX Recurrence Score (RS), tumor size, and nodal status into a Cox model, PathClinRS, fit using 60% of cases from TAILORx, with the remaining 40% held out for validation. The primary end point was distant recurrence-free interval. Performance was assessed using Harrell's concordance index (C-index) and Kaplan-Meier analyses. RESULTS: A total of 12,418 patients were included. In TAILORx, AI-Path outperformed RS for distant recurrence (C-index, 0.682 vs 0.647; P = .038), driven by superior prediction of late recurrence (0.656 vs 0.567; P < .001). In node-negative disease, PathClinRS outperformed RSClin in the TAILORx fitting (0.72 vs 0.70; P = .016) and validation sets (0.74 vs 0.70; P = .004). In node-positive disease, PathClinRS outperformed RSClinN+ in Chicago (0.94 vs 0.74; P < .001) and MDX-BRCA (0.71 vs 0.66; P = .004) cohorts. Compared with NATALEE eligibility, PathClinRS identified nearly twice as many high-risk node-negative patients while maintaining a comparable 10-year distant recurrence risk (16.7% vs 16.6% per NATALEE eligibility in TAILORx fitting; 21.0% vs 19.4% in TAILORx validation). PathClinRS identified 68% of intermediate risk premenopausal patients as low-risk with no evidence of chemotherapy benefit, compared to only 36% identified as low risk by standard clinicopathologic criteria. CONCLUSION: Digital histopathology provides prognostic information complementary to genomic assays and has the potential to personalize therapy beyond existing clinicogenomic tools.

Journal Article↗
PubMed1989

Quantitative evaluation of recurrent meningiomas.

Clinical, histological and karyometric parameters, nuclear DNA content and the number of nucleolar organizer regions were investigated in 9 recurrent meningiomas and 10 meningiomas which had not recurred within a 10-year period. There were no significant differences between the two groups as to age, sex, site of the tumours and most of the histological parameters scored. Recurrent tumours showed a higher number of mitotic figures and the nucleolus was visible in most of the cells. Cell density, nuclear area, perimeter and nuclear DNA content had values with no statistically significant differences between the two groups. However, significant differences were found in the distribution of the nuclei in the different ploidy regions. Most of the nuclei in the non recurrent cases were in the diploid range, whereas in recurrent tumours there was a reduction in the number of diploid cells associated with an increase in 2c--4c and 4c components. Recurrent tumours also showed a higher number of nucleolar organizer regions positively stained using an argyrophil method. The mitotic count and the nucleolar organizer regions appeared to be the best predictors for recurrence.

Adult↗
PubMed2026

Oncotype DX-guided vs physician-directed chemotherapy and survival in HR+/HER2- breast cancer.

BACKGROUND: Oncotype DX testing guides adjuvant chemotherapy decisions in early-stage hormone receptor-positive/HER2-negative breast cancer, but testing is not universally performed, and outcomes associated with genomic-informed versus clinicopathologic-based chemotherapy decision pathways remain unclear. METHODS: Using the 2022 National Cancer Database Breast Participant User File, we identified women diagnosed from 2010 to 2022 with pathologic T1b-T2, node-negative, hormone receptor-positive/HER2-negative invasive breast cancer who received adjuvant chemotherapy and endocrine therapy. Patients were classified into an Oncotype-guided group, defined by Oncotype DX testing with a recurrence score of 26 or higher, and a physician-directed group, defined by receipt of chemotherapy without genomic testing. The primary outcome was overall survival. Analyses used multivariable Cox models, logistic-IPTW and MLP-IPTW, restricted mean survival time analysis, and a Bayesian latent confounding survival model. RESULTS: Among 56,625 women, 27,278 were in the Oncotype-guided group and 29,347 in the physician-directed group. Median ages were 59 and 56 years, respectively. The Oncotype-guided group had more favorable overall survival than the physician-directed group in multivariable Cox analysis (HR, 0.906; 95% CI, 0.856-0.959; P&#x202f;<&#x202f;0.001), with similar findings in IPTW analyses. The association was concentrated among patients aged 56 years or older (HR, 0.866; 95% CI, 0.809-0.927; P&#x202f;<&#x202f;0.001). The Bayesian model showed no strong residual confounding signal. CONCLUSIONS: Among chemotherapy-treated women, an Oncotype-guided pathway was associated with more favorable overall survival than a physician-directed pathway, particularly among older patients, which indicating prognostic heterogeneity selected using genomic versus conventional clinicopathologic information.

Humans↗
PubMed1988

Intestinal mucosa diamine oxidase activity reflects intestinal involvement in Crohn's disease.

The activity of diamine oxidase (DAO), an enzyme found in the apical villous cells of the small intestine mucosa, should reflect the status of the intestinal mucosa. Our purpose was to determine whether DAO activity in the intestinal mucosa is diminished in patients with Crohn's disease and correlates with the severity of histological changes. Mucosal DAO activity was determined in 42 tissue specimens from patients with Crohn's enteritis (n = 15), Crohn's colitis (n = 9), and ulcerative colitis (n = 11), and from patients with no intestinal disease (n = 7). DAO activity was estimated by the metabolism of [14C]putrescine. Histologic changes were graded on a scale of 0-4. Normal histology was graded as zero, mild edema, and inflammation in the lamina propria as one, crypt abscess formation and inflammation as two, more severe inflammation plus or minus granulomata as three, and most severe inflammation with active ulceration as four. Tissue DAO activity was significantly less in patients with ileitis (4.8 +/- 3.6) compared with those with Crohn's colitis (15.0 +/- 11.6), ulcerative colitis (16.8 +/- 19.7), and normal intestine (17.6 +/- 14.3 U/mg protein/h, p less than 0.05). Intestinal DAO activity showed a positive correlation with the histologic scores. Recurrence of Crohn's disease developed postoperatively in two patients with low tissue DAO activity (1.4 and 2.9 U/mg protein/h). Intestinal DAO activity is diminished in patients with Crohn's ileitis and correlates with the severity of histologic changes. Tissue DAO activity might prove useful in predicting the risk of recurrence or anastomotic complications after resection for Crohn's disease.

Adult↗
PubMed1988

[Prediction of the hematogenic metastasis and local recurrence of rectal cancer by quantification of the clinico-pathological factors].

Clinico-pathological features of rectal cancers which caused hematogenic metastases, such as liver, lung and bone metastases, or local recurrence were studied. The influence of clinico-pathological factors on hematogenic metastases or local recurrence was quantified by using multivariate analysis. This study revealed that the degree of advance of the cancer like lymph node metastases and the extent of cancer cell invasion in rectal wall had great influence on hematogenic metastases. It also revealed that the character of the cancer, such as macroscopic figure, histological type, age and localization, had great influence on local recurrence. The personal score which was obtained by adding each score of clinico-pathological factors was related to the hematogenic metastasis or local recurrence. This score was thought to be useful for the prediction of the hematogenic metastasis and local recurrence of rectal cancer.

Female↗
PubMedDate not supplied

The Belsey Mark IV antireflux procedure: indications and long-term results.

UNLABELLED: From 1977 to 1990, a Belsey Mark IV antireflux procedure was performed in 177 patients. The primary indication was gastro-oesophageal reflux (GOR) resistant to medical treatment in all but 5 patients presenting themselves with a complicated para-oesophageal hernia. Ninety-eight patients (53.5%) had some form of additional pathology or complication: grade III oesophagitis: 26, grade IV: 6, Barrett's oesophagus: 38, reintervention: 14, concomitant duodenal ulcer requiring highly selective vagotomy: 14, bleeding: 23, small benign tumours: 2. There was one postoperative and one late mortality. At one year an objective evaluation was made in all patients operated on since this interval (N = 147), consisting in endoscopy: 121, Barium-swallow: 113, 24 hour oesophageal pH-monitoring: 81, manometry: 69. A recurrence was documented in 11 patients (7.4%). The mean follow-up of these 147 patients is 4.4 years with a range from 1 to 13 years. Over the entire follow-up period 17 patients (11.5%) had symptoms suggestive of recurrent reflux. Subjective and objective recurrence rate was 13%. Undesired gastrointestinal side effect were seen in 13 patients (8.8%), whereas post-thoracotomy pain was equally noticed in 13 patients (8.8%). The final score combining recurrence rate and side effects showed excellent to very good results in 77.5% of the patients, good results in 7.5% and bad results in 15%. CONCLUSION: Candidates for surgical treatment of GOR often present themselves with a variety of reflux related complications or additional pathology. Long term follow-up shows good reflux control in 87% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas.

A review of histologic classification systems for grading of malignancy in squamous cell carcinomas of the head and neck region is presented. Reasons behind the varying results obtained in studies using histomorphologic grading schemes are presented and potential errors involved in this type of clinical research are discussed. Requirements for the study of correlations between malignancy grade scoring, and recurrence and survival rates are presented. These include factors as patient selection, clinical staging, and follow-up principles. Special attention must be given to treatment modalities, establishment of negative surgical margins and occurrence of regional lymph node and/or distant metastases.

Carcinoma, Squamous Cell↗
PubMed1986

Fetal respiratory movements: only part of the biophysical profile.

In a period of 1.5 years, approximately 1000 women with high-risk pregnancy received sonographic examinations in the authors' laboratory. Of these patients, five women with postterm pregnancy were found to have oligohydramnios and no other reassuring body or limb movements, despite the finding in each case of regular, sustained fetal respiratory movements. Four of the five neonates had evidence of fetal compromise at birth and the fifth had intrauterine growth retardation but good Apgar scores. The recurrence of the problem emphasizes the need to consider fetal respiration as only one part of the total biophysical profile.

Amniotic Fluid↗
PubMed1990

Cass scores as a preoperative prediction for recurrences of cervical cancer after radical hysterectomy and pelvic lymphadenectomy at Srinagarind Hospital.

Risk factors for recurrence after radical hysterectomy and pelvic lymphadenectomy at Srinagarind Hospital was studied from 218 patients operated between 1976 to June 30, 1988. Four preoperative risk factors i.e., cell types, age, stages and size of the lesions were computed and cross-tabulated with the recurrence rate from the data of the whole patients. The correlation was found to be statistical significant. This scoring system should be called from the first letter of the factor as 'CASS' and used for selection of the patients for radical hysterectomy and pelvic lymphadenectomy.

Adult↗
PubMed1988

Psychological investigation of genital herpes recurrence: prospective assessment and cognitive-behavioral intervention for a chronic physical disorder.

Previous studies suggest that anxiety and/or depressed mood are associated with recurrence of genital herpes lesions. The present study sought to extend the assessment of factors associated with genital herpes and to investigate the impact of psychological therapy on features of the disorder. Sixteen genital herpes patients received 5 weeks of either structured discussion or cognitive restructuring (CR) therapy in a group format. Measures of attitude about herpes, global coping, distress, loneliness, health locus of control, and recurrence frequency were administered at pretreatment, posttreatment, and 3 months follow-up. Patients also made daily reports during the 5 weeks of treatment from which information was extracted regarding their herpes symptoms, dysphoria, anxiety, and ongoing coping process. Therapy did not produce the expected reductions in reported distress or loneliness. The CR procedure, however, was associated with reduced frequency of lesion recurrence at follow-up. Avoidant coping was associated with lower recurrence rates, and loneliness scores were associated with higher recurrence rates. Prospective data indicated that recurrences were preceded by elevated anxiety that was independent of prodromal symptoms. These results provide support for the general proposals that psychological factors influence health status and that psychological intervention may reduce disease recurrence.

Adaptation, Psychological↗
PubMed1985

Type A score (Jenkins Activity Survey) and risk of recurrent coronary heart disease in the aspirin myocardial infarction study.

The Jenkins Activity Survey (JAS), a questionnaire developed to assess the type A behavior pattern, was administered to 2,314 participants in the Aspirin Myocardial Infarction Study. All had a myocardial infarction (MI) before entering the study and were followed for at least 3 years. The JAS type A score was not significantly related to risk of recurrent major coronary events (definite nonfatal MI and coronary death) in the group of 244 women, the group of 2,070 men, or the subgroup of 671 men who were employed full-time in professional, technical or managerial positions. These results indicate that the JAS type A score is not useful in assessing prognosis after MI. By inference, traits measured by the JAS type A score, such as competitiveness, orientation toward achievement and preference for a rapid pace of life, appear not to be associated with increased risk of recurrent major coronary events.

Adult↗
PubMed1986

Correlation between morphometrical parameters and disease-free survival in ductal breast cancer treated only by surgery.

A combination of quantitatively evaluated morphological parameters and of conventional prognostic indicators has been used to study 19 cases of invasive ductal breast carcinoma from patients treated only by surgery, later developing recurrences or metastases. This set of patients not treated with adjuvant therapy (radiotherapy, cytostatic or hormonal therapy), was selected from 350 consecutive breast cancers which had been treated with surgical therapy. The aim was to investigate whether the morphometrical features are correlated with disease-free survival. Of the single features, the mitotic activity index (MAI) is most strongly correlated with prognosis. Ten of the 19 patients had an MAI value above 9, and all of them recurred within 18 months. In contrast, of the 9 other patients with low mitotic rate (MAI below or equal to 9), none recurred within 24 months. Further, a correlation exists between disease-free survival, mean and standard deviation of nuclear and nucleolar area, and tubular component of the tumors. There is no correlation between nuclear form factors and recurrence. The multivariate prognostic score is also significantly correlated with recurrence, but not as strongly as in other publications. This is obviously due to the blurring influence of the lymph node status, which was not significantly correlated with the prognosis. Thus, in this small set of patients not treated with any adjuvant therapy, the results of morphometric analysis are in agreement with earlier data and emphasize the prognostic significance of quantitative microscopical analysis in breast cancer.

Adult↗