Validation of Six Nomograms for Predicting Non-sentinel Lymph Node Metastases in a Dutch Breast Cancer Population

Autor: Roos M. van der Vuurst de Vries, Peter D. de Rooij, Leo M. Budel, Anne E. M. van der Pool, C. M. E. Contant, Siem A. Dingemans
Přispěvatelé: Graduate School, 02 Surgical specialisms
Rok vydání: 2015
Předmět:
Adult
Pathology
medicine.medical_specialty
Receptor
ErbB-2
Breast surgery
medicine.medical_treatment
Sentinel lymph node
Population
Breast Neoplasms
Breast Oncology
030230 surgery
03 medical and health sciences
0302 clinical medicine
Breast cancer
Humans
Medicine
Neoplasm Invasiveness
education
Lymph node
Aged
Neoplasm Staging
Retrospective Studies
Aged
80 and over
education.field_of_study
Models
Statistical
Sentinel Lymph Node Biopsy
business.industry
Carcinoma
Ductal
Breast
Axillary Lymph Node Dissection
Cancer
Middle Aged
Nomogram
Prognosis
medicine.disease
Carcinoma
Lobular
Nomograms
medicine.anatomical_structure
Receptors
Estrogen
Oncology
Area Under Curve
Lymphatic Metastasis
030220 oncology & carcinogenesis
Lymph Node Excision
Female
Surgery
Radiology
Receptors
Progesterone
business
Follow-Up Studies
Zdroj: Annals of Surgical Oncology
Annals of surgical oncology, 23(2), 477-481. Springer New York
ISSN: 1534-4681
1068-9265
DOI: 10.1245/s10434-015-4858-8
Popis: Background The usefulness of axillary lymph node dissection (ALND) in patients with positive sentinel nodes (SN) is still an ongoing debate. Several nomograms have been developed for predicting non-sentinel lymph node metastases (NSLNM). We validated six nomograms using data from 10 years of breast cancer surgery in our hospital. Methods We retrospectively analyzed all patients with a proven breast malignancy and a SN procedure between 2001 and 2011 in our hospital. Results Data from 1084 patients were reviewed; 260 (24 %) had a positive SN. No patients with isolated tumor cells, 6 patients (8 %) with micrometastases, and 65 patients (41 %) with macrometastases had additional axillary NSLNM. In 2 patients (3 %) with micrometastases, the ALND influenced postoperative treatment. In the group of patients with macrometastases tumor size >2 cm, extranodal growth and having no negative SNs were predictors of NSLNM. The revised MD Anderson Cancer Center and Helsinki nomograms performed the best, with an area under the curve value of 0.78. Conclusions ALND could probably be safely omitted in most patients with micrometastases but is still indicated in patients with macrometastases, especially in patients with tumor size >2 cm, extranodal growth, and no negative SNs. The revised MD Anderson Cancer Center and Helsinki nomograms were the most predictive in our patient group.
Databáze: OpenAIRE
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