tokens: RESULTS : Factors associated with significantly ( P < . 05 ) increased risk of treatment failure in a Cox multivariate analysis included age older than 45 years ( relative hazard , 1 . 17 ; 95 % confidence interval [ CI ] , 1 . 02 - 1 . 33 ) , Karnofsky performance score less than 90 % ( 1 . 27 ; 95 % CI , 1 . 07 - 1 . 51 ) , absence of hormone receptors ( 1 . 31 ; 95 % CI , 1 . 15 - 1 . 51 ) , prior use of adjuvant chemotherapy ( 1 . 31 ; 95 % CI , 1 . 10 - 1 . 56 ) , initial disease - free survival interval after adjuvant treatment of no more than 18 months ( 1 . 99 ; 95 % CI , 1 . 62 - 2 . 43 ) , metastases in the liver ( 1 . 47 ; 95 % CI , 1 . 20 - 1 . 80 ) or central nervous system ( 1 . 56 ; 95 % CI , 0 . 99 - 2 . 46 [ approaches significance ] ) vs soft tissue , bone , or lung , 3 or more sites of metastatic disease ( 1 . 32 ; 95 % CI , 1 . 13 - 1 . 54 ) , and incomplete response vs complete response to standard - dose chemotherapy ( 1 . 65 ; 95 % CI , 1 . 36 - 1 . 99 ) .