Predicting the extent of nodal involvement for node positive breast cancer patients: Development and validation of a novel tool.

Autor: van den Hoven I; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands., van Klaveren D; Department of Public Health, Center for Medical Decision Sciences, Erasmus MC, Rotterdam, The Netherlands., Verheuvel NC; Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., van la Parra RFD; Division of Surgery, Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Voogd AC; Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.; Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands., de Roos WK; Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands., Bosscha K; Department of Surgery, Jeroen Bosch Hospital, Den Bosch, The Netherlands., Heuts EM; Department of Surgery, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, The Netherlands., Tjan-Heijnen VCG; Department of Medical Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands., Roumen RMH; Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands.; Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands., Steyerberg EW; Department of Public Health, Center for Medical Decision Sciences, Erasmus MC, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2019 Sep; Vol. 120 (4), pp. 578-586. Date of Electronic Publication: 2019 Jul 23.
DOI: 10.1002/jso.25644
Abstrakt: Background: This study aimed to develop an easy to use prediction model to predict the risk of having a total of 1 to 2, ≥3, or ≥4 positive axillary lymph nodes (LNs), for patients with sentinel lymph node (SLN) positive breast cancer.
Methods: Data of 911 SLN positive breast cancer patients were used for model development. The model was validated externally in an independent population of 180 patients with SLN positive breast cancer.
Results: Final pathology after ALND showed additional positive LN for 259 (28%) of the patients. A total of 726 (81%) out of 911 patients had a total of 1 to 2 positive nodes, whereas 175 (19%) had ≥3 positive LNs. The model included three predictors: the tumor size (in mm), the presence of a negative SLN, and the size of the SLN metastases (in mm). At external validation, the model showed a good discriminative ability (area under the curve = 0.82; 95% confidence interval = 0.74-0.90) and good calibration over the full range of predicted probabilities.
Conclusion: This new and validated model predicts the extent of nodal involvement in node-positive breast cancer and will be useful for counseling patients regarding their personalized axillary treatment.
(© 2019 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.)
Databáze: MEDLINE
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